JP7437304B2 - medical equipment - Google Patents

Description

TECHNICAL FIELD The present invention relates to medical instruments for supporting surgery.

When inserting a medical device such as an introducer or a catheter device into a patient's blood vessel, a doctor or other operator must remove a part of the patient's body, taking into consideration the operability of the medical device and the ease of proceeding with the procedure. It may be held in a predetermined position. For example, Patent Document 1 discloses an arm rest cushion used to maintain the posture of a patient's arm when performing an artery puncture.

JP2017-79874

When using the above cushion, the operator places the patient's shoulders, arms, and hands on the cushion with the patient's elbows extended in a straight line. By using the cushion, the operator can stably hold the patient's body from the shoulder to the hand on the cushion without bending the patient's elbow. However, when the above-mentioned cushion is used, the following problems may occur depending on the content of the procedure.

For example, in catheterization using dTRA (distal transradial approach), in which the palmar artery running through the hand is punctured and treatment is performed via the puncture site, a medical device is inserted into the blood vessel running on the back side of the patient's hand. Move the medical device into the blood vessel running on the forearm side. In order to move the medical device smoothly within the blood vessel, the surgeon should position the patient's wrist so that the blood vessels running on the back of the hand and the blood vessels running on the forearm extend in a substantially straight line. The angle may be adjusted. Furthermore, the operator prevents the patient from moving the hand and forearm carelessly by fixing the position of the hand and forearm with the hand facing in a desired direction. This prevents the operator from forcibly bending and damaging the medical device inserted into the blood vessel when the patient moves his or her hand or forearm.

When the cushion described in Patent Document 1 is used in the above-mentioned catheter procedure using dTRA, the portion of the patient's body from the shoulder to the hand is arranged substantially in a straight line on the cushion body. Therefore, the surgeon cannot adjust the angle of the patient's wrist during surgery. Therefore, when the above-mentioned cushion is used, it becomes difficult to proceed with the procedure smoothly, and there is also a high possibility that the medical device will be damaged during the operation.

The present invention has been made in view of the above-mentioned problems, and is capable of preventing damage to the medical device inserted into the blood vessel during a procedure in which the device is inserted into the blood vessel from the back side of the patient's hand, and also allows the procedure to be performed. The aim is to provide medical equipment that enables smooth progress.

The medical device according to the present invention includes a first placing part on which the palm of a patient's hand is placed, a second placing part on which the forearm of the patient is placed, the first placing part and the first placing part. a fixing part that is disposed on at least one of the second mounting parts and fixes at least one of the hand and the forearm; a fixing part that connects the first mounting part and the second mounting part; a connecting part that can change the relative arrangement direction of the first placing part to the first placing part, and the connecting part is connected to a center line along the longitudinal direction of the first placing part in a plan view. The angle between the second mounting part and the center line along the longitudinal direction can be changed.

According to the above medical device, the operator moves the medical device along each blood vessel with the blood vessels running on the back side of the patient's hand and the blood vessels running on the patient's forearm extending in a substantially straight line. medical devices can be placed within each blood vessel. Therefore, the operator can smoothly move the medical device within the blood vessel, and can prevent the medical device inserted into the blood vessel from being damaged.

FIG. 1 is a plan view of a medical device according to an embodiment. FIG. 1 is a partial cross-sectional view of a medical device according to an embodiment. FIG. 2 is a front view of the first mounting section for medical instruments as seen from three directions of arrows shown in FIG. 1. FIG. FIG. 2 is a side view of the first placement section for medical instruments as seen from the four directions of arrows shown in FIG. 1. FIG. FIG. 2 is a cross-sectional view of the first mounting section taken along the arrow line 5-5 shown in FIG. 1. FIG. It is a perspective view of the 2nd mounting part of the medical instrument concerning an embodiment. FIG. 2 is a cross-sectional view of the second mounting portion taken along the arrow line 7-7 shown in FIG. 1. FIG. It is a perspective view showing an example of use of the medical instrument concerning an embodiment. It is a perspective view showing an example of use of the medical instrument concerning an embodiment. FIG. 7 is a perspective view showing a second mounting section according to Modification 1. FIG. FIG. 7 is a perspective view showing a second mounting section according to modification example 2;

A medical device 100 according to an embodiment will be described below with reference to FIGS. 1 to 9. Note that the dimensional ratios in the drawings are exaggerated for convenience of explanation and may differ from the actual ratios.

1 to 7 are diagrams for explaining each part of the medical instrument 100, and FIGS. 8 and 9 are diagrams for explaining an example of how the medical instrument 100 is used.

As shown in FIG. 1, FIG. 2, FIG. 8, and FIG. a second placing part 120 on which the patient's forearm A is placed; a first fixing part 130 placed on the first placing part 110 and fixing the patient's hand H; A second fixing part 140 that fixes the patient's forearm A, connects the first placing part 110 and the second placing part 120, and the relative arrangement of the first placing part 110 with respect to the second placing part 120. It has a connecting part 150 whose direction can be changed.

As shown in FIGS. 8 and 9, the medical device 100 is connected to a radial bone of a palmar artery (deep palmar artery) that runs on the back Hb of a hand (for example, right hand) H located on the finger side of a patient's forearm A. It can be used in a procedure (so-called dTRA) for an artery (for example, an artery around the snuff box or a distal radial artery running on the fingertip side of the snuff box) B1. Hereinafter, in this specification, the configuration of each part of the medical device 100 and an example of how the medical device 100 is used in dTRA will be described.

<First placement part>
As shown in FIGS. 2 and 5, the first mounting section 110 includes a main body 111 and a cover member 113 that covers the main body 111. Arrows a1-a2 shown in FIG. 2 indicate the longitudinal direction of the first mounting section 110 (the direction in which it is arranged from the patient's wrist W to the fingertips of the hand H).

The material forming the main body part 111 of the first placing part 110 is not particularly limited, but it should be flexible so that the patient does not feel pain when the patient places the palm Hp of the hand H on the first placing part 110. It is preferable to use a suitable material. For example, urethane can be used as such a material.

The main body part 111 of the first mounting part 110 may be made of different materials for each part of the main body part 111. For example, when using the medical device 100, the part on which the palm Hp of the patient's hand H is placed is made of a flexible material as described above, and the part on which the palm Hp of the patient's hand H is not placed is made of a hard material. It can be composed of materials.

Although the material forming the cover member 113 of the first mounting section 110 is not particularly limited, it is preferable to use a material that is resistant to chemicals used in surgery. As such materials, for example, synthetic leather, artificial leather, and natural leather can be used.

As shown in FIGS. 2 and 5, a first engaged member 170 in which an engagement groove 171 is formed is arranged inside the first mounting portion 110. The first engaged member 170 is arranged so that the extending direction of the engaging groove 171 coincides with the longitudinal direction of the first mounting section 110. A part of an engagement member 160, which will be described later, is engaged with the engagement groove 171.

The engagement groove 171 has a first portion 171a having a substantially spherical shape (circular in the cross-sectional view shown in FIG. 2), and a width (first mounting portion 110) that is wider than the first portion 171a in the cross-sectional view shown in FIG. The second portion 171b is formed to have a small dimension (in the direction intersecting the longitudinal direction). The first portions 171a and the second portions 171b are alternately arranged along the longitudinal direction of the engagement groove 171.

As shown in FIGS. 2 and 5, an opening exposed to the outside of the first mounting section 110 is formed in one end 170a of the first engaged member 170 that is disposed on the second mounting section 120 side. has been done. A closed end of the engagement groove 171 is formed at the other end 170b of the first engaged member 170, which is disposed on the opposite side from the one end 170a.

As shown in FIG. 3, FIG. 4, and FIG. 5, the first placing part 110 is formed at the base part 115 and at a position that most protrudes from the base part 115 toward the upper side where the palm Hp of the hand H is placed. It has an apex portion 116 and an inclined portion 117 connecting the base portion 115 and the apex portion 116.

The base portion 115 forms the bottom of the first mounting portion 110 . The base portion 115 has a flat surface. When using the medical instrument 100, the operator can, for example, place the base portion 115 on the patient's abdomen or on the bed on which the patient lies.

The apex portion 116 is held between the patient's thumb f1 and index finger f2 when the patient places the palm Hp of the hand H on the first placement portion 110 (see FIGS. 8 and 9). By arranging the thumb f1 and index finger f2 so as to be hooked on the apex portion 116, the patient can prevent the positions of the fingers f1 and f2 from shifting from the first placement portion 110.

In the inclined portion 117, the height of the first mounting portion 110 gradually decreases from the apex portion 116 toward the base portion 115. In the first placing part 110, the apex part 116 of the first placing part 110 is at the highest position, and the periphery of the apex part 116 extends along a predetermined ridge line toward the base part 115 side with the apex part 116 as a reference. The height is gradually decreasing as shown. Therefore, as shown in FIGS. 8 and 9, when the patient places the palm Hp of the hand H on the first placing part 110, the patient's hand Hp follows the shape of the inclined part 117 of the first placing part 110. The instep Hb has a convexly curved shape.

The shape and size of the first placement part 110 are not particularly limited as long as the palm Hp of the patient's hand H can be placed thereon. However, each part of the first mounting part 110 can be formed with the following example dimensions, for example.

The angle θ1 between the base portion 115 and the inclined portion 117 shown in FIG. 3 is, for example, 45°. Further, the angle θ2 between the base portion 115 and the inclined portion 117 shown in FIG. 4 is, for example, 20°. The length L1 of the base portion 115 (the length along the longitudinal direction of the first mounting portion 110) is, for example, 130 mm. The height H1 of the first mounting section 110 (distance between the base section 115 and the apex section 116) is, for example, 60 mm.

<Second mounting section>
As shown in FIGS. 2, 6, and 7, the second mounting section 120 includes a main body 121 and a cover member 123 that covers the main body 121. Arrows b1-b2 shown in FIG. 2 indicate the longitudinal direction of the second mounting section 120 (the direction in which it is arranged along the patient's forearm A).

The material for forming the main body 121 of the second mounting section 120 is not particularly limited, but for example, the same material as the main body 111 of the first mounting section 110 can be used. Note that, similarly to the main body 111 of the first receiver 110, the main body 121 of the second receiver 120 has a portion where a part of the patient's body (forearm A) is not placed. It can be made of a harder material than the other parts. Although the material forming the cover member 123 of the second mounting section 120 is not particularly limited, for example, the same material as the cover member 113 of the first mounting section 110 can be used.

As shown in FIGS. 2 and 7, a second engaged member 180 in which an engagement groove 181 is formed is arranged inside the second mounting portion 120. The second engaged member 180 is arranged so that the extending direction of the engaging groove 181 coincides with the longitudinal direction of the second mounting section 120. A part of an engagement member 160, which will be described later, is engaged with the engagement groove 181.

As shown in FIGS. 2 and 7, an opening exposed to the outside of the second mounting section 120 is formed in one end 180a of the second engaged member 180 that is disposed on the first mounting section 110 side. has been done. A closed end of the engagement groove 181 is formed at the other end 180b of the second engaged member 180, which is disposed on the opposite side from the one end 180a.

The engagement groove 181 has a first portion 181a having a substantially spherical shape (circular in the cross-sectional view shown in FIG. 2), and a width (second mounting portion 120) that is wider than the first portion 181a in the cross-sectional view shown in FIG. The second portion 181b is formed to have a small dimension (in the direction intersecting the longitudinal direction). The first portions 181a and the second portions 181b are arranged alternately along the longitudinal direction of the engagement groove 181.

As shown in FIG. 6, the second mounting portion 120 has an approximately triangular prism outer shape.

As shown in FIGS. 6 and 7, the second mounting portion 120 includes a bottom portion 125, a first side wall portion 126 rising from the bottom portion 125, and a second side wall inclined from the bottom portion 125 toward the first side wall portion 126. 127.

The bottom portion 125 has a flat surface. When using the medical instrument 100, the operator can, for example, place the bottom portion 125 on the patient's abdomen or on the bed on which the patient is lying.

The first side wall portion 126 is erected in a substantially straight line along the height direction of the second mounting portion 120 . The upper end portion 126a of the first side wall portion 126 corresponds to the highest apex portion of the second mounting portion 120.

The second side wall portion 127 forms a plane that extends linearly while being inclined from the bottom portion 125 toward the upper end portion 126a of the first side wall portion 126. Since the second side wall part 127 has an inclined plane, when the patient's forearm A is placed on the second side wall part 127 of the second placing part 120 (see FIGS. 8 and 9), the patient's forearm A is It is arranged obliquely along the shape of the second side wall portion 127 . When the patient's forearm A is placed on the second side wall portion 127 in this manner, the inner side of the forearm A located on the thumb f1 side of the hand H is directed toward the upper end portion 126a of the first side wall portion 126.

The shape and size of the second placement section 120 are not particularly limited as long as at least a portion of the patient's forearm A can be placed thereon. However, each part of the second mounting part 120 can be formed with the following example dimensions, for example.

The angle θ3 between the bottom portion 125 and the second side wall portion 127 shown in FIG. 6 is, for example, preferably 20° to 70°, and more preferably 45°. Further, the length L2 of the bottom portion 125 (the length along the longitudinal direction of the second mounting portion 120) is, for example, 150 mm to 250 mm. The height H2 of the second mounting portion 120 (distance between the bottom portion 125 and the upper end portion 126a of the first side wall portion 126) is, for example, 60 mm.

<Connection part>
As shown in FIG. 2, the connecting portion 150 includes an engaging member 160, a first engaged member 170 that is disposed within the first mounting portion 110 and engages with the engaging member 160, and a second A second engaged member 180 is disposed within the portion 120 and engages with the engaging member 160.

The engagement member 160 has a plurality of main body parts 161 and a covering part 162 arranged so as to partially cover the main body part 161.

The main body portion 161 has a bulging portion 161a formed in a substantially spherical shape and a constriction portion 161b connected to the bulging portion 161a.

The bulging portion 161a is partially covered by a covering portion 162. Each of the main body parts 161 is configured to be slidable along the inner surface of the covering part 162 while being covered by the covering part 162.

When changing the relative arrangement direction of the first mounting section 110 and the second mounting section 120, the surgeon The main body portion 161 of the engaging member 160 exposed to the outside of the placement portion 120 is slid against the covering portion 162. When the main body part 161 slides with respect to the covering part 162, the first placing part 110 swings relative to the second placing part 120, and the direction in which the first placing part 110 is arranged changes. Be changed. Note that when changing the arrangement direction of each of the mounting sections 110 and 120, the operator may move only one of the first mounting section 110 and the second mounting section 120, or move only one of the first mounting section 110 and the second mounting section 120. and the second mounting section 120 may be moved simultaneously.

Note that the above-mentioned "arrangement direction" refers to the direction of the center line c1 along the longitudinal direction of the first mounting section 110 and the center along the longitudinal direction of the second mounting section 120 in the plan view shown in FIG. It means the direction of line c2. Moreover, the above-mentioned "relatively changing the arrangement direction" means changing the angle θc between the center line c1 of the first placing part 110 and the center line c2 of the second placing part 120. do.

As shown in FIG. 2, the first mounting section 110 and the second mounting section 120 are connected via an engagement member 160. In the engaging member 160, the plurality of main body parts 161 arranged on the first mounting part 110 side engage with the engagement grooves 171 of the first engaged member 170 arranged inside the first mounting part 110. ing. Further, in the engaging member 160, the plurality of main bodies 161 disposed on the second placing part 120 side are engaged with the engaging grooves 181 of the second engaged member 180 disposed inside the second placing part 120. It matches.

In this embodiment, the bulging portion 161a of the main body portion 161 of the engaging member 160 has a substantially spherical shape, and the inner surface of the covering portion 162 that covers the bulging portion 161a is a part of the outer surface of the bulging portion 161a. It has a concave shape that can be covered. Therefore, the operating direction of the main body 161 of the engaging member 160 is limited to only the rotational direction in the plan view shown in FIG. It is possible to rotate three-dimensionally with respect to the covering part 162 without being rotated. Therefore, the operator can three-dimensionally adjust the arrangement direction of the first mounting section 110 and the arrangement direction of the second mounting section 120. Since the operator can adjust the shape of the medical instrument 100 into a three-dimensional shape, the degree of freedom in the posture of the patient's hand H and forearm A placed on the medical instrument 100 can be increased.

The connecting section 150 according to the present embodiment also has a function as an angle holding section that maintains the relative arrangement direction of the first mounting section 110 with respect to the second mounting section 120. More specifically, a portion of the engaging member 160 included in the connecting portion 150 that is not engaged with the engaging groove 171 of the first engaged member 170 and the engaging groove 181 of the second engaged member 180 constitutes the above-mentioned angle holding section.

The bulging portion 161a of the engaging member 160 included in the connecting portion 150 generates a frictional force with the covering portion 162 by coming into contact with the inner surface of the covering portion 162. The main body portion 161 is prevented from inadvertently rotating relative to the covering portion 162 due to the frictional force generated between the bulging portion 161a of the engagement member 160 and the covering portion 162. Therefore, the engaging member 160 included in the connecting portion 150 is composed of a portion that is not engaged with the engaging groove 171 of the first engaged member 170 and the engaging groove 181 of the second engaged member 180. The angle holding section can prevent the arrangement direction of the first mounting section 110 and the second mounting section 120 from being changed unintentionally.

Furthermore, the connecting section 150 according to the present embodiment also has a function as a distance changing section that allows changing the distance between the first mounting section 110 and the second mounting section 120. More specifically, the portion of the engaging member 160 included in the connecting portion 150 that engages with the engaging groove 171 of the first engaged member 170 and the engaging groove 181 of the second engaged member 180 constitutes the distance changing section described above.

As shown in FIG. 2, the main body portion 161 of the engaging member 160 included in the connecting portion 150 is accommodated in the engaging groove 171 of the first engaged member 170 disposed within the first mounting portion 110. The operator moves the main body portion 161 of the engaging member 160 along the longitudinal direction of the first mounting portion 110 to the other end side of the engaging groove 171 (the other end portion 170b side of the first engaged member 170). By pushing in, the main body portion 161 of the engagement member 160 can be moved toward the other end of the engagement groove 171 . Thereby, the distance between the first mounting section 110 and the second mounting section 120 becomes smaller. The operator also moves the main body 161 of the engaging member 160 along the longitudinal direction of the first mounting section 110 to the one end side of the engaging groove 171 (to the one end 170a side of the first engaged member 170). By pulling, the main body 161 of the engagement member 160 can be moved toward one end of the engagement groove 171. This increases the distance between the first mounting section 110 and the second mounting section 120.

When the body portion 161 of the engagement member 160 moves along the engagement groove 171 as described above, the body portion 161 moves from the predetermined first portion 171a of the engagement groove 171 to the adjacent first portion 171a. It moves over the second portion 171b of the matching groove 171. The operator pushes and pulls the engaging member 160 with such force that the main body 161 of the engaging member 160 can overcome the second portion 171b, thereby separating the adjacent first portions 171a. The main body portion 161 can be moved.

In this embodiment, the first portion 171a of the engagement groove 171 is formed to have a size that can generate a frictional force with the covering portion 162 of the engagement member 160. Further, the second portion 171b of the engagement groove 171 has an outer diameter smaller than the outer diameter (maximum outer diameter) of the covering portion 162 of the engagement member 160 in the cross-sectional view shown in FIG. Therefore, the body portion 161 of the engagement member 160 is held in the predetermined first portion 171a of the engagement groove 171 when the operator does not intentionally apply force to move the engagement member 160. maintain. Therefore, of the engagement member 160 included in the connecting portion 150, the distance changing portion constituted by the portion engaged with the engagement groove 171 of the first engaged member 170 is connected to the first mounting portion 110 and the second mounting portion. It is possible to prevent the distance from the mounting section 120 from being changed inadvertently.

The operator moves the main body part 161 of the engaging member 160 disposed on the second mounting part 120 side along the longitudinal direction of the engaging groove 181 of the second engaged member 180, thereby It is also possible to change the distance between the placing section 110 and the second placing section 120. The specific procedure is the same as that for moving the engaging member 160 along the engaging groove 171 of the first engaged member 170. The first portion 181a and the second portion 181b of the engagement groove 181 of the second engaged member 180 are similar to the first portion 171a and the second portion 171b of the engagement groove 171 of the first engaged member 170, When the operator applies force to move the main body 161 of the engaging member 160, while allowing the main body 161 of the engaging member 160 to move, a large external force is applied to the main body 161 of the engaging member 160. In a state in which no attachment is provided, the configuration is such that careless movement can be prevented. Therefore, of the engagement member 160 included in the connecting portion 150, the distance changing portion constituted by the portion engaged with the engagement groove 181 of the second engaged member 180 is connected to the first mounting portion 110 and the second mounting portion. It is possible to prevent the distance from the mounting section 120 from being changed inadvertently.

The material forming the main body portion 161 of the engagement member 160 is not particularly limited, but for example, resin materials such as polypropylene, polyethylene terephthalate, polymethyl methacrylate, polycarbonate, and ultraviolet curing resin, glass, ceramics, etc. can be used.

Although the material forming the covering portion 162 of the engaging member 160 is not particularly limited, it is necessary to generate a predetermined frictional force between the covering portion 162 of the engaging member 160 and the engaged members 170 and 180. It is preferable to use a material that can. Examples of such materials include various rubber materials such as natural rubber, butyl rubber, isoprene rubber, butadiene rubber, styrene-butadiene rubber, and silicone rubber, as well as polyurethane-based, polyester-based, polyamide-based, olefin-based, and styrene-based materials. Various thermoplastic elastomers can be used.

Note that the shape, size, and number of the main body portion 161 and the covering portion 162 of the engaging member 160, the shape, size, and engagement of the engagement groove 171 of the first engaged member 170, and the engagement of the second engaged member 180 The shape, size, etc. of the groove 181 are not particularly limited. In addition, in this embodiment, the engaged members are arranged in the first placing part 110 and the second placing part 120, and the distance between the first placing part 110 and the second placing part 120 is set at the connecting point. 150, but for example, by forming an engagement groove only on one of the mounting sections, the distance between the first mounting section 110 and the second mounting section 120 can be changed. may be configured. Furthermore, although the connecting portion according to the present embodiment is configured to have the functions of an angle holding portion and a distance changing portion, the angle holding portion and the distance changing portion are formed of separate members from the connecting portion. It's okay.

<First fixed part, second fixed part>
As shown in FIGS. 8 and 9, the first fixing part 130 is used to fix the patient's hand H to the first placing part 110.

The first fixing part 130 has a main body part 131 arranged along the outer circumference of the patient's hand H, and a fastener 132 for adjusting the length of the main body part 131.

The main body portion 131 of the first fixing portion 130 can be configured with, for example, a rubber band (elastically deformable band-like member). As shown in FIGS. 8 and 9, the operator places the palm Hp of the patient's hand H on the first placing part 110, and then places the main body part 131 of the first fixing part 130 on the patient's hand H. Arrange it so that it wraps around the outside. The patient's hand H is fixed to the first mounting part 110 by receiving the tightening force applied by the main body part 131 of the first fixing part 130.

As shown in FIGS. 8 and 9, the second fixing part 140 is used to fix the patient's forearm A to the second mounting part 120.

The second fixing part 140 has a main body part 141 arranged along the outer circumference of the patient's forearm A, and a fastener 142 for adjusting the length of the main body part 141.

The main body part 141 of the second fixing part 140 can be made of, for example, a rubber band, similarly to the main body part 131 of the first fixing part 130. As shown in FIGS. 8 and 9, the operator wraps the main body part 141 of the second fixing part 140 around the outer periphery of the patient's forearm A with the patient's forearm A placed on the second placing part 120. Place it like this. The patient's forearm A is fixed to the second mounting part 120 by the tightening force applied by the main body part 141 of the second fixing part 140.

The first fixing section 130 is configured as a separate body that is not integrated with the first mounting section 110 so that it can be separated from the first mounting section 110. Similarly, the second fixing section 140 is configured as a separate body that is not integrated with the second mounting section 120 so that it can be separated from the second mounting section 120. Note that the first fixing part 130 may be integrally attached to the first mounting part 110 so that it cannot be separated from the first mounting part 110. Similarly, the second fixing part 140 may be integrally attached to the second mounting part 120 so that it cannot be separated from the second mounting part 120.

Further, the specific configuration of each of the fixing parts 130 and 140 is not particularly limited, and for example, they may be configured to include a belt-shaped main body part provided with a hook-and-loop fastener or the like. Moreover, the medical instrument 100 only needs to include at least one of the first fixing part 130 and the second fixing part 140, and does not need to include both the first fixing part 130 and the second fixing part 140.

<Example of use of medical equipment>
Next, an example of how the medical device 100 is used will be described with reference to FIGS. 8 and 9.

As shown in FIG. 8, in the dTRA procedure, the operator places the palm Hp of the patient's hand H to face the first placement part 110. Further, the operator places the patient's forearm A on the second placement section 120. At this time, the patient holds the apex portion 116 of the first placement portion 110 between the thumb f1 and index finger f2 of the hand H. Further, the patient places the palm Hp of the hand H on the inclined part 117 of the first placing part 110 and places the forearm A on the second side wall part 127 of the second placing part 120.

The operator adjusts the angle of the patient's wrist W so that the blood vessel B1 running on the back Hb side of the patient's hand H and the blood vessel (radial artery) B2 running on the patient's forearm A side form a straight line. . At this time, the operator adjusts the arrangement direction of the first mounting section 110 and the arrangement direction of the second mounting section 120. After determining the positions and arrangement directions of the patient's hand H, forearm A, and wrist W, the operator fixes the patient's hand H on the first mounting part 110 using the first fixing part 130, and then fixes the patient's forearm A on the first mounting part 110. It is fixed to the second mounting section 120 by the second fixing section 140 .

With the patient's hand H and forearm A fixed relative to the medical instrument 100, the operator places the puncture site t1 connected to the blood vessel B1 running on the back Hb side of the patient's hand H, as shown in FIG. Form. Next, the operator inserts the introducer 200 into the blood vessel B1 running on the back Hb side of the patient's hand H via the puncture site t1.

Next, the operator directs the sheath tube 210 of the introducer 200 toward the central side of the patient's body along the blood vessel B1 running on the back Hb side of the patient's hand H and the blood vessel B2 running on the forearm A side. move it. After delivering the tip of the sheath tube 210 of the introducer 200 to a desired site of the patient's body, the operator inserts various medical devices (for example, a treatment device such as a balloon catheter, or a diagnostic image) through the introducer 200. (such as a catheter device to obtain the

By using the medical instrument 100, the operator can hold the patient's hand in a state where the blood vessel B1 running on the back Hb side of the patient's hand H and the blood vessel B2 running on the forearm A side are extended in a substantially straight line. H and forearm A can be secured to the medical device 100. Therefore, the operator can smoothly move the introducer 200 and various medical devices along the blood vessels B1 and B2 during the surgery.

Furthermore, by using the medical instrument 100, the surgeon can fix the patient's hand H and forearm A to the medical instrument 100, thereby preventing the patient from moving the hand H and forearm A carelessly. It can be prevented. Therefore, the operator can prevent the sheath tube 210 of the introducer 200 inserted into each blood vessel B1, B2 and various medical devices from being bent and damaged due to bending of the hand H or forearm A. .

As described above, the medical device 100 according to the present embodiment includes the first placement section 110 on which the palm Hp of the patient's hand H is placed, and the second placement section 120 on which the patient's forearm A is placed. a first fixing part 130 that is placed on the first placing part 110 and fixes the patient's hand H; a second fixing part 140 that is placed on the second placing part 120 and fixes the patient's forearm A; It has a connecting part 150 that connects the first placing part 110 and the second placing part 120 and can change the relative arrangement direction of the first placing part 110 with respect to the second placing part 120. There is.

According to the medical device 100 according to the present embodiment, the operator can check the state in which the blood vessel B1 running on the back Hb side of the patient's hand H and the blood vessel B2 running on the patient's forearm A side extend in a substantially straight line. , the sheath tube 210 of the introducer 200 can be moved along each blood vessel B1, B2, or the sheath tube 210 of the introducer 200 can be placed in each blood vessel B1, B2. Therefore, the operator can smoothly move the sheath tube 210 of the introducer 200 and various medical devices within each blood vessel B1, B2, and the sheath tube 210 of the introducer 200 inserted into each blood vessel B1, B2. Damage to the tube 210 and various medical devices can be prevented.

The first placing section 110 also includes a base section 115, an apex section 116 formed at the most protruding position from the base section 115 toward the upper side where the palm Hp of the patient's hand H is placed, and the base section 115. It has an inclined part 117 that connects the apex part 116. Therefore, the patient can stably place the hand H on the first placement section 110 by sandwiching the vertex 116 between the fingers f1 and f2 of the hand H placed on the first placement section 110. can do. In addition, by placing the palm Hp of the hand H along the slope 117, the patient can take a relaxed posture without having to extend the hand H straight toward the fingertips, thereby reducing stress during the surgery. It can be reduced.

Further, the second mounting portion 120 includes a bottom portion 125, a first side wall portion 126 rising from the bottom portion 125, and a second side wall portion 127 inclined from the bottom portion 125 toward the first side wall portion 126 side. There is. Therefore, when the patient places the forearm A on the second placing part 120, the inner side of the forearm A located on the thumb f1 side of the hand H is tilted so as to face the upper end 126a side of the first side wall part 126. placed in the state. When using the medical device 100, the operator positions the patient's forearm A as described above, so that the blood vessel B1 running on the back of the hand Hb side and the blood vessel B2 running on the forearm A side extend in a substantially straight line. The patient's posture can be adjusted accordingly. Therefore, when the medical device 100 is used in a dTRA procedure, it becomes extremely useful as an instrument that supports the procedure.

The connecting portion 150 also includes an engaging member 160, a first engaged member 170 that is disposed within the first mounting portion 110 and engages with the engaging member 160, and a first engaged member 170 that is disposed within the second mounting portion 120. and a second engaged member 180 that is engaged with the engaging member 160. The connecting portion 150 stably maintains the connection between the first mounting portion 110 and the second mounting portion 120 via the engaging member 160, the first engaged member 170, and the second engaged member 180. be able to.

Furthermore, the medical instrument 100 includes an angle holding section that maintains the relative arrangement direction of the first mounting section 110 with respect to the second mounting section 120. The angle holding portion is constituted by a portion of the engaging member 160 that is not engaged with the first engaged member 170 and the second engaged member 180. When changing the arrangement direction to a desired direction, the angle holding section can be used to maintain the arrangement direction of the first mounting section 110 in the desired direction. Therefore, the operator can prevent the arrangement direction of the first mounting section 110 from being changed carelessly during the surgery. Therefore, the operator must appropriately maintain the patient's posture during surgery so that the blood vessel B1 running on the back of the hand Hb side and the blood vessel B2 running on the forearm A side extend in a substantially straight line. It becomes possible.

Furthermore, the medical device 100 includes a distance changing section that allows the distance between the first mounting section 110 and the second mounting section 120 to be changed. The distance changing portion is constituted by a portion of the engaging member 160 that engages with the first engaged member 170 and the second engaged member 180. The operator uses the distance changing section to change the distance between the first mounting section 110 and the second mounting section 120 according to individual differences in the patient's body, thereby adjusting the medical device 100 in various ways. It becomes possible to use it on patients. Therefore, the convenience of the medical instrument 100 is further improved by having the distance changing section.

(Modified example of second placement part)
FIG. 10 shows a second mounting section 320 according to a first modification, and FIG. 11 shows a second mounting section 420 according to a second modification. Note that in FIGS. 10 and 11, only the external shapes of the second mounting portions 320 and 420 are shown, and illustrations of the connecting portion 150 and the like are omitted.

As shown in FIG. 10, at least a portion of the patient's forearm A is placed in a portion (second side wall portion 127) that is arranged facing the patient's forearm A in the second placement portion 320 according to the first modification. An insertable recess 328 is formed. When placing the patient's forearm A on the second placement section 320, the operator can hold the forearm A more stably on the second placement section 320 by inserting the forearm A into the recess 328. I can do it. Note that the specific shape (cross-sectional shape, etc.) of the recess 328 is not particularly limited.

As shown in FIG. 11, the second placing section 420 according to the second modification has a recess 428 into which at least a part of the patient's forearm A can be inserted, similarly to the second placing section 320 according to the first modification. have. Further, the second mounting portion 420 has a rounded and curved overall external shape. The other configuration of the second mounting section 320 according to the second modification is substantially the same as the second mounting section 320 according to the first modification.

Although the medical device according to the present invention has been described above through the embodiments, the present invention is not limited to each configuration described in the specification, and may be modified as appropriate based on the description of the claims. It is possible.

In the description of the embodiment, an example of the use of the medical instrument when performing surgery on the patient's right hand has been described, but the medical instrument can also be used when performing surgery on the patient's left hand. In this case, the positional relationship of each part of the medical instrument (for example, the first placement part and the second placement part) can be changed as appropriate so that the patient's left hand can be placed thereon.

This application is based on Japanese Patent Application No. 2018-152670 filed on August 14, 2018, the disclosure content of which is incorporated by reference in its entirety.

100 Medical equipment,
110 first mounting section,
115 base part,
116 Apex part,
117 Slope,
120, 320, 420 second mounting section,
125 bottom,
126 first side wall portion,
127 second side wall part,
130 first fixed part (fixed part),
140 second fixed part (fixed part),
150 connection part,
160 Engagement member, angle holding part, distance changing part,
161 Main body of engagement member,
162 Covering portion of engaging member,
170 first engaged member,
171 Engagement groove of first engaged member,
180 second engaged member,
181 Engagement groove of second engaged member,
200 introducer,
210 sheath tube,
328, 428 recess,
A forearm,
B1, B2 blood vessels,
H hand,
Hb back of hand,
HP palm of the hand,
W wrist,
f1 thumb,
f2 index finger,
t1 puncture site.

Claims (7)

a first placement part on which the patient's palm is placed;
a second placement part on which the patient's forearm is placed;
a fixing part that is disposed on at least one of the first mounting part and the second mounting part and fixes at least one of the hand and the forearm;
a connection part that connects the first mounting part and the second mounting part and can change the relative arrangement direction of the first mounting part with respect to the second mounting part ,
The connecting part is capable of changing an angle between a center line along the longitudinal direction of the first mounting part in a plan view and a center line along the longitudinal direction of the second mounting part in a plan view. utensils. The first placement part includes a base part, an apex part formed at a position most protruding from the base part toward the upper side where the palm of the hand is placed, and an inclined part connecting the base part and the apex part. The medical device according to claim 1, comprising: and. 1 . The second mounting portion includes a bottom portion, a first side wall portion rising from the bottom portion, and a second side wall portion inclined from the bottom portion toward the first side wall portion . Or the medical device according to claim 2 . 4. The recess according to claim 1, wherein a recess into which at least a part of the forearm can be inserted is formed in a portion of the second mounting portion that is arranged to face the forearm. medical equipment. The connecting portion includes an engaging member, a first engaged member that is disposed within the first mounting portion and engages with the engaging member, and a first engaged member that is disposed within the second mounting portion and engages with the engaging member. 5. The medical device according to claim 1, further comprising a second engaged member that engages with the second engaged member. an angle holding part that holds the relative arrangement direction of the first mounting part with respect to the second mounting part;
6. The medical device according to claim 5, wherein the angle holding portion is constituted by a portion of the engaging member that is not engaged with the first engaged member and the second engaged member. comprising a distance changing section that allows changing the distance between the first mounting section and the second mounting section;
The distance changing portion is configured by a portion of the engaging member that engages with the first engaged member and the second engaged member. medical equipment.