JP3061461B2 - Tubular insert - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a tubular insertion tool such as a catheter, an endoscope, a laser probe and the like which is used by being inserted into a living body cavity.

[0002]

2. Description of the Related Art In general, for example, many tubular insertion tools such as medical catheters and endoscopes are provided with a bending device for bending a distal end portion of an insertion portion. For example, Japanese Patent Application Laid-Open No. 3-86144 discloses a bending device of this type which is made of a shape memory alloy (hereinafter, referred to as SMA) at a distal end of an insertion portion of a tubular insertion tool such as an endoscope, and stores an extended state. A bending mechanism for providing a bending operation wire as a compression-formed wire-shaped elastic driving member and bending a distal end portion of an insertion portion of an insertion tool such as an endoscope in accordance with a shape return operation of the bending operation wire is shown. Have been.

[0003]

Problems to be Solved by the Invention Japanese Patent Laid-Open No. 3-86144
In the insertion portion of the tubular insertion tool disclosed in Japanese Patent Application Laid-Open No. H10-209, a bending portion made of a similar multi-lumen tube is provided at the distal end of a flexible tube portion made of a multi-lumen tube. And SM
The bending operation wire of A is inserted into the lumen (through hole) of the tube of the bending portion, and both ends thereof are fixed at the rear end (the distal end side of the flexible tube) of the multi-lumen tube of the bending portion.

[0004] In this case, the multi-lumen tube of the curved portion is formed of a flexible material. Further, the multi-lumen tube of the flexible tube portion is formed of a material having good slipperiness. The insertion portion of the tubular insertion tool is formed by connecting two types of tubes formed of these different materials.

Here, for example, heat-resistant and flexible material such as silicon is used for the multi-lumen tube of the curved portion, and Teflon which is heat-resistant and has a good sliding property is used for the multi-lumen tube of the flexible tube portion. (Dupont company name) and the like have been used, but there has been a problem that it is difficult to reliably connect the tubes to each other.

Therefore, there is a possibility that a gap may be formed at a joint between the multi-lumen tube of the bending portion and the multi-lumen tube of the flexible tube portion. Salt solution or the like) may enter the insertion lumen of the SMA bending operation wire from this gap, and the bending performance may be degraded and safety may be reduced.

SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances, and it is possible to reliably join a bending portion and a flexible tube portion, and to prevent liquid from penetrating into an insertion lumen of a bending operation wire. It is an object of the present invention to provide a tubular insert capable of preventing the deterioration of the performance and preventing the deterioration of the performance and improving the safety.

[0008]

SUMMARY OF THE INVENTION The present invention relates to a multi-lumen tubular insertion tool in which a curved portion is provided at a distal end of a flexible tube forming an insertion portion of a tubular insertion tool body. The bending portion is formed by inserting a bending operation wire made of a shape memory alloy whose length is contracted by heating into the lumen of the tube, and the flexible tube portion is formed by a single lumen tube having flexibility. A joint is provided at the front end of the single lumen tube to which the rear end of the multi-lumen tube is adhered, and a skin tube is provided to cover the entire single lumen tube from the rear end of the multi-lumen tube, A lead wire for supplying electricity to the bending operation wire is provided between the single lumen tube and the outer tube.

[0009]

[Function] By coating a highly slippery outer tube from the rear end of the multi-lumen tube to the entire single-lumen tube, only the heat resistance is required as the material of the flexible tube portion composed of the single-lumen tube, Is not required, so that a material having good adhesiveness to the multi-lumen tube of the bending portion can be selected and used as the material of the flexible tube portion, and the joining between the bending portion and the flexible tube portion can be performed. It is intended to be performed reliably.

[0010]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, a first embodiment of the present invention will be described with reference to FIGS. 1 and 2 show a schematic configuration of a main part of the medical catheter (tubular insertion tool) 1 shown in FIG.

The main body of the catheter 1 has an insertion portion 1a. The insertion portion 1a is provided with a flexible tube portion 2 and a curved portion 23 provided at a distal end of the flexible tube portion 2. A balloon 3 formed of a bag-shaped elastic body is mounted on the outer peripheral surface of the distal end portion of the insertion portion 1a.

Further, a proximal end 4 is provided at the proximal end of the insertion portion 1a. A connecting end 6 of the tube 5 and a connecting end 8 of a cable 7 described later are provided on the outer peripheral surface of the proximal end 4. In this case, one end side of the tube 5 is connected to the inside of the balloon 3. Further, a syringe 9 for supplying a fluid such as physiological saline into the balloon 3 is detachably connected to the other end of the tube 5.

An endoscope insertion port 10 is provided on the end face of the proximal end 4. And this endoscope insertion port 1
From 0, the insertion portion 12 of the vascular endoscope 11 formed by, for example, an electronic endoscope is inserted into the tube of the catheter body.

The insertion portion 12 of the blood vessel endoscope 11 is formed by connecting a distal end component 14 to a distal end of a flexible tube 13. Furthermore, one end of each of universal cords 16 and 17 is connected to the proximal operation section 15 on the proximal end side of the insertion section 12. The other end of one universal cord 16 is connected to a light source device 19 via a connector 18, and the other end of the other universal cord 17 is connected to a television camera unit 21 via a connector 20. The television camera unit 21 includes a television monitor 2
2 are connected.

On the other hand, the curved portion 23 of the catheter 1 is
It is configured as shown in (A) and (B). That is, the bending portion 23 is provided with a flexible silicon multi-lumen tube 24 adhered or welded to the distal end surface of the flexible tube portion 2.

The multi-lumen tube 24 has a structure shown in FIG.
As shown in (A), a central lumen 25 is formed in the center of the shaft as a central through-hole for forming a channel for inserting a guide wire, a very small diameter scope, or the like. Further, on both sides of the central lumen 25, side lumens 26a and 26b, which are a pair of side through holes extending in the axial direction, are provided.

The multi-lumen tube 24 has a recess 26c at the distal end thereof for communicating between a pair of side lumens 26a and 26b. A bending operation wire 27 is inserted into these side lumens 26a and 26b.

The bending operation wire 27 is formed of a shape memory material such as a linear shape memory alloy (SMA). The SMA of the bending operation wire 27 has, for example, a two-way shape memory effect. The bending operation wire 27 is formed by forming a wire whose length is contracted by heating into an elongated shape.

That is, the bending operation wire 27 has a first memorized shape (initial wire shape) on the high temperature side of the length L _{0 and} a low temperature side of the length L ₁ (L ₁ = L ₀ + ΔL). The second memory shape (forced extension wire shape) is stored. In this case, after the SMA of the bending operation wire 27 is subjected to the shape memory processing on the high temperature side in the first memory shape on the high temperature side, the SMA is forcibly expanded into the elongated shape at room temperature, for example, about the body temperature, and the second memory on the low temperature side. Shape storage processing of the stored shape is performed. Then, in a state where the bending operation wire 27 that has been subjected to the shape memory processing in two directions is held in the second memory shape,
By heating the bending operation wire 27 to a transformation temperature of, for example, about 60 to 90 ° C. or more, the bending operation wire 27 is deformed (returned to a shape) of a first memory shape (heat-shrinkable wire shape) on the high temperature side having a length L _0. It has become.

As shown in FIG. 2, the bending operation wire 27 is folded back from a substantially central portion, and the folded wire components on both sides are formed as a pair of side lumens 26a, 26b.
Is inserted in each. The central folded portion of the bending operation wire 27 is the multi-lumen tube 2
4 is inserted into the recess 26c, and is fixed in this state by the adhesive S filled in the recess 26c.

The distal ends of the two folded wire portions of the bending operation wire 27 protrude from the inside of the multi-lumen tube 24 toward the flexible tube portion 2, and the protruding portions are connected to the lead wires 28a, 28b for energization. Are connected at one end. Ring-shaped caulking members 2 are provided at these connection portions.
9 is used.

That is, as shown in FIG. 2, each end of the folded wire constituting portion of the bending operation wire 27 and one end of each of the lead wires 28a and 28b are inserted into the ring of the caulking member 29, and are overlapped. In this state, the caulking members 29 in each of the side lumens 26a and 26b are crushed and caulked. Then, in this state, each end of the folded wire component of the bending operation wire 27 and the lead wires 28a, 28
b is electrically connected to one end thereof.

The outer diameter of the caulking member 29 is formed to be larger than the diameter of the side lumens 26a and 26b of the multi-lumen tube 24. Therefore, both folded wire constituent portions of the bending operation wire 27 and the lead wire 28
a and 28b are connected to each other by a caulking member 29, and the distal ends of both folded wire components of the bending operation wire 27 are connected to the rear ends of the side lumens 26a and 26b of the multi-lumen tube 24. Is firmly fixed.

The flexible tube section 2 of the catheter 1 is provided with a silicone tube 30 which is a single lumen tube having flexibility. This silicone tube 3
0 is bonded to the rear end surface of the multi-lumen tube 24 with an adhesive S '.

In this case, the inner diameter of the silicon tube 30 is formed to be the same as the inner diameter of the central lumen 25 of the multi-lumen tube 24. A joint 30a is formed by joining the silicon tube 30 and the multi-lumen tube 24 in a state where the lumen of the silicon tube 30 is communicated with the central lumen 25 of the multi-lumen tube 24.

Further, the outer circumference of the silicon tube 30 is covered with an outer tube 30b made of a heat-shrinkable tube such as Teflon (trade name of DuPont) having a high sliding property. In this case, the distal end portion of the outer tube 30b is firmly fixed in a state of being externally fitted to the outer peripheral surface of the rear end portion of the multi-lumen tube 24 as shown in FIG.

Further, lead wires 28a and 28b are inserted between the silicon tube 30 and the outer tube 30b. Further, the hardness of the flexible tube portion 2 of the catheter 1 can be made higher than that of the multi-lumen tube 24 of the bending portion 23 by the outer tube 30b, and the contraction operation of the bending operation wire 27 is applied only to the bending portion 23. Can be.

The other end of each of the lead wires 28a and 28b is connected to an energization amount control unit 31 for controlling the amount of energization of the bending operation wire 27. The power supply controller 31 is connected to the main body of the catheter 1 via the cable 7. Further, an operation unit 33 is connected to the energization amount control unit 31 via a cable 32.

The operation section 33 is formed by a joystick 34, for example. This joystick 3
Reference numeral 4 denotes a movable operation in both sides from a central reference position, which is normally held at the reference position.

The controller for the bending operation wire 27 is built in the power supply amount control unit 31. The controller is provided with a variable resistor and a switch connected to a power supply. The controller operates the joystick 34, that is, the switch and the variable of the controller according to the moving direction and the moving amount of the joystick 34 from the reference position. The bending direction and the bending amount of the bending portion 23 of the catheter 1 can be arbitrarily operated in a state where the resistor is appropriately switched and operated so as to correspond to the moving amount of the joystick 34.

Next, the operation of the above configuration will be described.
First, the joystick 34 of the catheter 1 is normally held at the reference position. In this state, the energization amount control unit 31
Since the switch of the controller is held in the off state, the bending operation wire 27 of the bending portion 23 is held in a state where power is not supplied. Therefore, since the bending operation wire 27 is held in the second memory shape of the cold side of the length dimension L _1, it is held in a substantially linear regular shape state the curved portion 23 is not bent in the insertion portion 1a You.

When the vascular endoscope 11 is used, as shown in FIG.
For example, it is inserted into the blood vessel 38. In this case, the insertion portion 1a
The balloon 3 is used to fix the inside of the blood vessel 38.

When the balloon 3 is used, a syringe 9 is connected to the proximal end of the tube 5, and a fluid such as a physiological saline solution is supplied from the syringe 9 through the tube 5 into the bag of the balloon 3. Therefore, the balloon 3 is inflated by the supply of the fluid, and the inflated balloon 3 is pressed against the inner wall surface of the blood vessel 38. In this state, the insertion portion 1a of the catheter 1 is fixed at a predetermined position in the blood vessel 38.

Then, in this state, the insertion section 12 of the vascular endoscope 11 is inserted from the endoscope insertion port 10 of the catheter 1 into the tube of the catheter 1 (in the silicon tube 30 and in the central lumen 25 of the multi-lumen tube 24). Is done.

When the distal end component 14 of the blood vessel endoscope 11 is directed in a desired direction such as the thrombus 39 in the blood vessel 38, the bending portion 23 of the catheter 1 is bent. The joystick 34 is used at the time of the bending operation of the bending portion 23 of the catheter 1. In this case, the joystick 34
Is moved by an arbitrary amount in one direction from the reference position. Then, the switch of the controller and the variable resistor are appropriately switched according to the operation of the joystick 34, that is, the moving direction and the moving amount of the joystick 34 from the reference position.

That is, when the joystick 34 is moved, a switch of the controller is turned on.
The variable resistor of one of the controllers of one of the bending operation wires 27 of the SMA is moved to a predetermined position. Then, in accordance with this switching operation, one of the bending operation wires 27 connected to the controller is selectively energized and heated.

Further, the bending operation wire 2 which is electrically heated
7 is deformed into the first memory shape of the high temperature side, for example, the length dimension L _0, the length of the bending operation wire 27 is contracted. Therefore, in this state, the bending portion 23 of the insertion portion 1a is pulled by the bending operation wire 27 to contract the front end fixed end of the bending operation wire 27 with respect to the fixing portion of the caulking members 29 on the rear end side. The front end side of the bending portion 23 is bent toward the bending operation wire 27 that contracts.

In this case, the amount of bending of the bending portion 23 is appropriately set in accordance with the amount of movement of the joystick 34, that is, the amount of movement of the variable resistor of the controller, and the deformable range of the bending operation wire 27 (length L) ₁ low temperature side 2
(The range between the stored shape of (1) and the first stored shape on the high temperature side of the length L ₀ ) can be set arbitrarily.

When the joystick 34 is returned to the reference position, the variable resistor of the controller is returned to a predetermined return position, the switch is turned off, and the heating of the bending operation wire 27 connected to the controller is performed. Stopped. Therefore, decrease the temperature of the bending operation wire 27 in this state, since the bending operation wires 27 in a contracted state to return to the second memory shape of the cold side of the length dimension L _1, a contracted state of the bending operation wire 27 With the shape return operation, the curved portion 23 of the insertion portion 1a is returned to a substantially straight, uncurved, normal shape.

Therefore, in the above configuration, since the outer tube 30b having a high sliding property is covered from the rear end portion of the multi-lumen tube 24 of the curved portion 23 to the entire silicon tube 30, the single-lumen tube can be used. As a material of the silicon tube 30 of the flexible tube portion 2, only heat resistance is required, and slippage is not required.

For this reason, a material having good adhesiveness to the multi-lumen tube 24 of the bending portion 23 can be selected and used as a material of the silicon tube 30 of the flexible tube portion 2. Bonding between the portion 2 and the silicon tube 30 can be reliably performed. As a result, it is possible to prevent the liquid from penetrating into the side lumens 26a and 26b through which the bending operation wire 27 is inserted, thereby preventing performance degradation and improving safety.

The SMA bending operation wire 27 is connected to a pair of side lumens 26a of the multi-lumen tube 24.
26b extending in the axial direction, and a bending mechanism of the bending portion 23 was formed by the bending operation wire 27.
The diameter of the entire bending mechanism can be reduced, and the configuration can be simplified.

Further, since the flexible tube portion 2 of the insertion portion 1a is formed by the silicon tube 30 which is a single lumen tube, the diameter of the insertion portion 1a can be reduced, and the insertion into the channel of the endoscope can be realized. In addition to improving the performance, insertion into a thinner biological conduit is facilitated.

The lead wires 28a and 28b are connected to the outer tube 3 made of a silicon tube 30 and a heat shrink tube.
0b, the catheter 1
Can be greatly improved.

FIG. 4 shows a second embodiment of the present invention. This is an application of the present invention to a blood vessel endoscope 61. That is, a flexible tube portion 62 having the same configuration as the flexible tube portion 2 of the catheter 1 of the first embodiment is provided in the insertion portion 61a of the blood vessel endoscope 61, and the flexible tube portion 62 is provided. Is provided with a curved portion 63 having the same configuration as the curved portion 23 of the catheter 1 of the first embodiment.

Further, one end of each of universal cords 65 and 66 is connected to an operation section 64 provided at the base end of the insertion section 61a of the blood vessel endoscope 61. The other end of one universal cord 65 is connected to a light source device 68 via a connector 67, and the other end of the other universal cord 66 is connected to a television camera unit 70 via a connector 69.

A television monitor 71 is connected to the television camera unit 70. Further, a power supply amount control unit 73 is connected to the light source device 68 via a cable 72. An operation unit 75 formed by, for example, a joystick 74 is connected to the power supply amount control unit 73. And also in this case, the curved portion 63 at the tip of the insertion portion 61a.
However, similarly to the first embodiment, the bending amount can be arbitrarily operated in a state corresponding to the moving amount of the joystick 74.

Therefore, also in this case, the flexible tube portion 62 having the same configuration as the flexible tube portion 2 of the catheter 1 of the first embodiment is provided in the insertion portion 61a of the blood vessel endoscope 61, and this is provided. Since the bending portion 63 having the same configuration as the bending portion 23 of the catheter 1 of the first embodiment is provided at the distal end of the flexible tube portion 62, the same effect as that of the first embodiment can be obtained. .

FIGS. 5A and 5B show a third embodiment of the present invention. This is an application of the present invention to a medical catheter having substantially the same configuration as that of the medical catheter 1 of the first embodiment, and the same parts as those in FIGS. The description is omitted, and only different portions will be described here.

That is, in this embodiment, a cooling lumen 81 is provided between the two sets of side lumens 26a and 26b and the outer peripheral surface of the multi-lumen tube 24 of the curved portion 23.
Are provided.

In this case, the caulking member 2 for connecting between both ends of the bending operation wire 27 and the lead wires 28a, 28b.
9 is a side lumen 26 of the multi-lumen tube 24
a, it is fixed by the adhesive S ₁ while being inserted into the proximal side of the 26b. And the side lumen 26a,
Opening of the proximal side of 26b is sealed by the adhesive S _1.

Further, the flexible tube 2 is provided with a slidable tube 82 made of, for example, Teflon (trade name of DuPont), polyethylene or the like having the same outer diameter as the multi-lumen tube 24 of the curved portion 23. I have. This tube 82
Is joined to the rear end of the multi-lumen tube 24 by an adhesive or the like. And this tube 8
An outer skin tube 30 composed of a heat shrink tube on the outer peripheral surface of 2
b is coated.

The silicon tube 30 and the tube 8
A cooling water passage 83 communicating with the cooling lumen 81 is formed in a gap between the cooling water passage 83 and the cooling lumen 81. In this case, catheter 1
The cooling water supply device (not shown) connected to the cooling water passage 83 is connected to the proximal end 4 of the cooling water supply device. The cooling water supplied from the cooling water supply device is guided into the cooling lumen 81 via the cooling water passage 83 between the silicon tube 30 and the tube 82.

Therefore, the multi-lumen tube 2 of the curved portion 23 has the same structure as in the first embodiment.
4 covers the entire outer surface of the silicon tube 30 from the rear end portion thereof, so that the outer tube 30b having a high sliding property is covered.
3 and a material having good adhesiveness to the multi-lumen tube 24 can be selected and used, and the bonding between the curved portion 23 and the silicon tube 30 of the flexible tube portion 2 can be reliably performed. Therefore, in this embodiment, similarly to the first embodiment, it is possible to prevent liquid from penetrating into the side lumens 26a and 26b through which the bending operation wire 27 is inserted, thereby preventing performance deterioration and ensuring safety. Performance can be improved.

Further, in this embodiment, two sets of side lumens 2 in the multi-lumen tube 24 of the bending portion 23 are used.
Since the cooling lumen 81 is provided between the outer peripheral surface and each of the multi-lumen tubes 2 of the bending portion 23 by the cooling water flowing in the cooling lumen 81.
By cooling 4, the surface temperature of the tube 24 can be prevented from rising to a high temperature state.

[0056] Also, side lumen 26a, since the opening of the proximal end of 26b were sealed with adhesive S _1, side lumen 26a of the bending operation wire 27 is inserted, 26
It is possible to more reliably prevent the liquid from entering the b.

The lead wires 28a, 28b of this embodiment
Are arranged in a mesh on the outer peripheral surface of the silicon tube 30 to increase the rigidity of the flexible tube portion 2 and
It is also possible to improve the torque transmission of the catheter 1.

FIGS. 6A and 6B show a fourth embodiment of the present invention. This is a modification of the configuration of the curved portion 23 of the medical catheter having substantially the same configuration as the medical catheter 1 of the first embodiment.

That is, in this embodiment, a substantially U-shaped hard wire receiving member 91 is provided at the inner bottom of the concave portion 26c of the multi-lumen tube 24 into which the central folded portion of the bending operation wire 27 is inserted. The wire receiving member 91 is formed of a conductive member such as copper.

Further, the bent portions 91a, 91a at both ends of the wire receiving member 91 are inserted into the front ends of the side lumens 26a, 26b as shown in FIG. The portion is disposed on the wire receiving member 91 as shown in FIG.

Both ends of the bending wire 27 of the SMA are fixed in the side lumens 26a, 26b via a caulking member 29 whose outer diameter is slightly larger than the inner diameter of the side lumens 26a, 26b. .

Further, the silicone adhesive 92 is filled in the recess 26c of the multi-lumen tube 24 in a watertight manner, so that the bending operation wire 27 of the SMA and the outside of the main body of the catheter 1 are insulated.

During the bending operation of the bending portion 23 of the catheter 1, the bending operation wire 27 of one SMA is selectively provided.
Is heated by energization, and the heated SMA wire 27 contracts in the axial direction. In this case, the proximal end side of the SMA wire 27 is fixed in the side lumen 26a of the multi-lumen tube 24 by a caulking member 29, and the distal end side is a folded back portion via a hard wire receiving member 91 via the multi-lumen tube 24. Since it is fixed to the concave portion 26c of
A compressive force acts on the multi-lumen tube 24 in the direction indicated by the arrow in FIG. Therefore, the bending portion 23 of the catheter 1 is bent in the direction indicated by the arrow in FIG.

Therefore, in the above-mentioned structure, a substantially U-shaped hard wire receiving member 91 is provided at the inner bottom of the concave portion 26c of the multi-lumen tube 24 into which the center folded portion of the bending operation wire 27 is inserted. So catheter 1
When stress is concentrated on the folded portion of one of the SMA bending operation wires 27 that is energized and heated at the distal end of the bending portion 23 during the bending operation of the bending portion 23, the stress is dispersed by the wire receiving member 91. Can be done.

Therefore, the stress concentrated on the folded portion of the bending operation wire 27 is applied to the multi-lumen tube 24.
Can be prevented from directly acting on the tube wall surface of the inner bottom of the concave portion 26c of the multi-lumen tube 24, so that the wall of the tube wall of the inner bottom of the concave portion 26c of the multi-lumen tube 24 can be prevented from being cut off.

Furthermore, since the substantially U-shaped hard wire receiving member 91 is formed of a conductive member, the electrical resistance is reduced at the folded portion of the SMA bending operation wire 27, and heat generation at the distal end surface of the catheter 1 is suppressed. be able to.

The silicone adhesive 92 is filled in the recess 26c of the multi-lumen tube 24 in a watertight manner,
Since the bending operation wire 27 of A and the outside of the main body of the catheter 1 are insulated, even when the bending operation wire 27 is energized, current does not leak to the outside of the catheter 1.

FIG. 7 shows a modification of the fourth embodiment shown in FIGS. 6 (A) and 6 (B). This is provided with a wire receiving member 101 formed of a hard thin disk that receives the center folded portion of the bending operation wire 27 on the distal end surface of the multi-lumen tube 24 of the bending portion 23.

The wire receiving member 101 has the same cross-sectional shape as the multi-lumen tube 24, and is made of an insulating member such as ceramic or hard plastic. Furthermore, a central hole 102 and side holes 103a and 103b communicating with the central lumen 25 and the side lumens 26a and 26b of the multi-lumen tube 24 are formed on the surface of the thin disk of the wire receiving member 101, respectively. ing. The wire receiving member 101 is fixed to the distal end surface of the multi-lumen tube 24.

Further, the bending operation wire 27 is configured such that the folded wire components on both sides of the central folded portion are the wire receiving members 10.
1 and a pair of side lumens 2 through the side holes 103a and 103b.
6a and 26b, respectively, and the central folded portion of the bending operation wire 27 is disposed on the wire receiving member 101.

Further, a cap 104 made of, for example, Teflon (trade name of DuPont) is water-tightly fitted on the distal end surface of the multi-lumen tube 24 of the bending portion 23 so as to cover the wire receiving member 101. The cap 104 is formed with a chemical liquid injection hole 105 communicating with the central lumen 25 of the multi-lumen tube 24.

Therefore, in the above-mentioned configuration, the center turning portion of the bending operation wire 27 is received by the wire receiving member 101 formed of a hard thin disk provided on the distal end surface of the multi-lumen tube 24 of the bending portion 23. Therefore, in this case, as in the fourth embodiment, the stress concentrated on the folded portion of the bending operation wire 27 of one of the SMAs which is electrically heated during the bending operation of the bending portion 23 of the catheter 1 causes the multi-lumen tube 24. Can be prevented from directly acting on the tube wall surface at the distal end surface, and the tube wall surface of the multi-lumen tube 24 can be prevented from being cut off.

Further, since the wire receiving member 101 formed of a thin disk is formed of an insulating material,
Even if the central folded portions of the two SMA bending operation wires 27, 27 are fixed on the same wire receiving member 101, no electric interference occurs.

Further, a cap 104 made of, for example, Teflon (trade name of DuPont) is water-tightly fitted on the distal end surface of the multi-lumen tube 24 of the bending portion 23 so as to cover the wire receiving member 101. Even when electricity is supplied to the catheter 27, no current leaks out of the catheter 1.

FIG. 8 shows a living vessel used to prevent the mixing of arterial and venous blood when the autologous vein is grafted at the time of treatment for vascular occlusion and the arterial vascular occlusion site is bypassed by the autologous vein. This shows a road blocker 111. A substantially spherical base material 112 is
And a physiologically active layer 113 coated on the outer surface of the substrate 112.

The physiologically active layer 113 is formed of a porous material such as foamed polyurethane (urethane sponge) into which cells can enter. The pore size of the porous body of the bioactive layer 113 is preferably about 5 to 500 μm.

When the living body channel closing device 111 is used, the catheter 114 is inserted in a state where the living body channel closing device 111 and the insertion pusher 115 are inserted into the catheter 114 as shown in FIG. Is inserted into the vein 116.

Further, the distal end of the catheter 114 is guided to a connection port of a blood vessel such as a target vein side branch 117 to be occluded, and the channel opening at the distal end of the catheter 114 is set to face the vein side branch 117. Thereafter, the insertion pusher 115 is pushed in, and as shown in FIG.
Insert.

After the living body channel closing device 111 is inserted into the vein side branch 117 in this way and a thrombus is formed in the vein side branch 117, the fiber is inserted into the hole of the physiologically active layer 113 of the living body channel closing device 111. The blast cells, and subsequently the vascular endothelial cells, invade and become matrix.

Therefore, in the above-mentioned structure, the physiologically active layer 113 is coated on the outer surface of the base material 112 of the living-body obstruction device 111, so that the thrombus is inserted into the vein side branch 117 by the living-body obstruction device 111. Is formed, fibroblasts and subsequently vascular endothelial cells enter the pores of the physiologically active layer 113 of the biological conduit occlusion device 111, thereby forming the biological conduit occlusion device 111 relatively quickly as a substrate. Can be done. Therefore, formation of an excessive thrombus in the vein side branch 117 can be prevented.

FIG. 10 shows a modified example of the living body channel closing device 121. The living-body obstructing device 121 is provided with a porous substrate 122 having a different shape formed of a material such as porous ceramics, and a physiologically active layer 123 coated on the outer surface of the porous substrate 122. ing. The physiologically active layer 123 is formed of a porous material such as foamed polyurethane (urethane sponge) into which cells can enter.

Further, the living-body-line obstructing device may be formed by a wound body in which a sheet-like mesh is wound. Further, the base material of the living body duct obstructing device is formed of substantially spherical silicon rubber, and the outer surface of the base material is, for example, ET such as Gore-Tex.
You may make it the structure covered with the physiologically active layer formed of FE. It should be noted that the present invention is not limited to the above-described embodiments, and it goes without saying that various modifications can be made without departing from the spirit of the present invention.

[0083]

According to the present invention, a bending portion is formed by inserting a bending operation wire made of a shape memory alloy whose length is contracted by heating into the lumen of a flexible multi-lumen tube, and A flexible tube portion is formed by a single lumen tube having flexibility, and a joint portion in which a rear end portion of the multi-lumen tube is bonded to a front end portion of the single lumen tube is provided, and from a rear end portion of the multi-lumen tube. An outer sheath tube covering the entire single lumen tube is provided, and a lead wire for energizing the bending operation wire is arranged between the single lumen tube and the outer sheath tube, so that the joint between the bending portion and the flexible tube portion is reliably ensured. To prevent liquid from penetrating into the insertion lumen of the bending operation wire, preventing performance degradation and ensuring safety. It is possible to improve the.

[Brief description of the drawings]

FIG. 1 shows a schematic configuration of a main part of a medical catheter according to a first embodiment of the present invention, in which (A) is a transverse sectional view of a multi-lumen tube having a curved portion, and (B) is a longitudinal sectional view thereof. .

FIG. 2 is a perspective view showing a connection state between a bending operation wire and an energizing lead wire.

FIG. 3 is an overall schematic configuration diagram showing a use state.

FIG. 4 is an overall schematic configuration diagram showing a second embodiment of the present invention.

FIG. 5 shows a third embodiment of the present invention;
(A) is a cross-sectional view of a multi-lumen tube having a curved portion,
(B) is the same longitudinal sectional view.

FIG. 6 shows a fourth embodiment of the present invention;
(A) is a longitudinal sectional view of a multi-lumen tube having a curved portion,
(B) is a top view which shows the front-end | tip surface of the multi-lumen tube of a bending part.

FIG. 7 is an exploded perspective view showing a modification of the fourth embodiment.

FIG. 8 is a cross-sectional view showing a living body duct obstructing device.

FIG. 9 is a view showing an operation of inserting a living body duct obstructing device;
(A) is a longitudinal cross-sectional view showing a state where the insertion catheter is inserted up to the connection port of the vein side branch, and (B) is a longitudinal cross section showing a state where the living body channel closing device is inserted into the vein side branch from the insertion catheter. FIG.

FIG. 10 is a transverse cross-sectional view showing a modified example of the living-body channel closing device.

[Explanation of symbols]

1a, 61a: insertion portion, 2, 62: flexible tube portion, 23, 6
3 ... Bending part, 24 ... Multi-lumen tube, 27 ... Bending operation wire, 28a, 28b ... Lead wire, 30 ... Silicon tube (single lumen tube), 30a ...
Junction, 30b ... Skin tube.

Claims (1)

(57) [Claims] 1. A tubular insertion tool in which a curved portion is provided at a distal end of a flexible tube forming an insertion portion of a tubular insertion tool body, wherein a flexible multi-lumen tube is heated in a lumen thereof. The bending portion is formed by inserting a bending operation wire made of a shape memory alloy whose length is contracted, and the flexible tube portion is formed by a flexible single-lumen tube, and the single-lumen tube is A joint portion in which a rear end portion of the multi-lumen tube is adhered to a distal end portion, and an outer tube covering the entire single lumen tube from the rear end portion of the multi-lumen tube is provided, and the single lumen tube and the outer tube are provided. A lead wire for energizing the bending operation wire is disposed between the lead wire and the bending operation wire.