Patent ID: 12193701

DESCRIPTION OF EMBODIMENTS

Hereinafter, embodiments will be described with reference to the drawings. It is noted that dimensional ratios in the drawings are exaggerated for convenience of description and may differ from actual ratios. In the present specification, a side of a medical device10to be inserted into a body cavity is referred to as a “distal end” or a “distal side”, and a side to be operated by an operator is referred to as a “proximal end” or a “proximal side”.

A medical device10according to an embodiment is inserted into a blood vessel in an acute lower limb ischemia or a deep vein thrombosis, and is used for a procedure for destroying and removing a thrombus, a plaque, an atheroma, a calcified lesion, and the like. It is noted that an object to be removed is not necessarily limited to the thrombus, the plaque, the atheroma, and the calcified lesion, and any object that may be present in a body cavity or a body-cavity can be removed by the medical device10.

As shown inFIGS.1and2, the medical device10includes a shaft portion15including a long drive shaft20that is rotationally driven, and an outer tube30that accommodates the drive shaft20. A handle portion17is provided at a proximal portion of the shaft portion15. A cutting portion40that cuts an object such as a thrombus is provided at a distal portion of the drive shaft20.

The drive shaft20transmits a rotational force to the cutting portion40. A lumen22for conveying the cut object to the proximal side is formed in the drive shaft20. The drive shaft20penetrates the outer tube30, and the cutting portion40is fixed to the distal portion thereof. The drive shaft20has, at the distal end, an inlet portion26into which debris (e.g., cut thrombus or the like), that is, an object to be aspirated, enters.

The drive shaft20is flexible and has a characteristic capable of transmitting a rotational power applied from the proximal side to the distal side. The drive shaft20may be formed of one member as a whole, or may be formed of a plurality of members. The drive shaft20may have a spiral slit or groove formed by laser processing or the like in order to adjust rigidity along the rotational axis. In addition, the distal portion and a proximal portion of the drive shaft20may be formed of different members.

As a constituent material for the drive shaft20, for example, stainless steel, a shape memory alloy such as a nickel-titanium alloy, an alloy made of silver, copper, zinc, and the like (e.g., silver brazing filler metal), an alloy made of gold, tin, and the like (e.g., solder component), a cemented carbide such as tungsten carbide, polyolefins such as polyethylene and polypropylene, polyamides, polyesters such as polyethylene terephthalate, fluoropolymers such as an ethylene tetrafluoroethylene copolymer (ETFE), polyether ether ketone (PEEK), and polyimides can be preferably used. In addition, the drive shaft20may be made of a plurality of materials, and a reinforcing member such as a wire rod may be embedded therein.

The outer tube30includes an outer tube main body31that rotatably accommodates the drive shaft20, and a distal tube32that is fixed to a side surface of a distal portion of the outer tube main body31.

The distal portion of the outer tube main body31is located on a proximal side of the cutting portion40. By rotating the outer tube main body31, the cutting portion40can be directed to an object to be removed. In addition, the outer tube main body31may include a curved portion bent at a predetermined angle at the distal portion thereof. By rotating the curved portion in the outer tube main body31, the cutting portion40can easily contact an object to be removed.

The distal tube32is fixed to an outer peripheral surface of the distal portion of the outer tube main body31. The distal tube32has a guide wire lumen33into which a guide wire can be inserted. Therefore, the medical device10is a rapid exchange type device in which the guide wire lumen33is formed only at a distal portion thereof.

Constituent materials for the outer tube main body31and the distal tube32are not particularly limited, and for example, stainless steel, a shape memory alloy such as a nickel-titanium alloy, titanium, an alloy made of silver, copper, zinc, and the like (e.g., silver brazing filler metal), an alloy made of gold, tin, and the like (e.g., solder component), a cemented carbide such as tungsten carbide, polyolefins such as polyethylene and polypropylene, polyamides, polyesters such as polyethylene terephthalate, or various elastomers, fluoropolymers such as ETFE, PEEK, polyimides, and polyacetal can be preferably used. In addition, the outer tube main body31may be made of a plurality of materials, and a reinforcing member such as a wire rod may be embedded therein.

The cutting portion40is a cutter that cuts and remove an object such as a thrombus, a plaque, or a calcified lesion. Therefore, the “cut” means applying a force to such an object in contact to make the object smaller. A method for applying the force in the cutting and a shape or a form of the object after the cutting are not limited. The cutting portion40has enough strength to cut the above-described object. The cutting portion40is fixed to the distal portion of the drive shaft20. The cutting portion40is a cylinder that protrudes toward the distal side with respect to the drive shaft20. A sharp blade41is disposed at a distal end of the cutting portion40. It is noted that a shape of the blade41is not particularly limited. The cutting portion40may include a large number of minute abrasive grains instead of the blade41.

A constituent material for the cutting portion40preferably has sufficient strength to cut a thrombus, and for example, stainless steel, titanium, diamond, ceramics, a shape memory alloy such as a nickel-titanium alloy, a cemented carbide such as tungsten carbide, an alloy made of silver, copper, zinc, and the like (e.g., (silver brazing filler metal), and high speed steel can be preferably used. The constituent material for the cutting portion40may be a resin such as engineering plastics such as polyether ether ketone (PEEK) and polyacetal.

The handle portion17will be described. As shown inFIG.3, the handle portion17includes a housing60, and an operation switch61for an operator to perform operation is provided on a distal side of the housing60. A rotation driving source65, which is a motor, a fluid driving source66, which is a pump, and a power supply portion67, which is a battery, are accommodated inside the housing60. The rotation driving source65rotationally drives the drive shaft20. The fluid driving source66moves a fluid from a distal side to a proximal side of the lumen22. The power supply portion67is connected to the rotation driving source65and the fluid driving source66, and supplies a power to them.

The housing60includes a hollow accommodation portion63on the distal side thereof. A connection portion50of the shaft portion15is provided at the proximal portion thereof and is accommodated in the accommodation portion63. The connection portion50of the shaft portion15includes a rotation connection portion51and a fluid connection portion52therein. Therefore, positions of the rotation connection portion51and the fluid connection portion52are fixed.

The shaft portion15is branched inside the connection portion50. The drive shaft20is interlocked with the rotation connection portion51of the shaft portion15whose central axis is coaxial with the drive shaft20. The lumen22is drawn out toward a branch tube53side branched from the shaft portion15, and the fluid connection portion52is provided at a distal portion of the branch tube53.

As shown inFIG.4, the rotation connection portion51of the shaft portion15includes a shaft insertion portion51athat is open to the proximal side. The rotation driving source65of the handle portion17includes a rotation connection portion71protruding into the accommodation portion63. The rotation connection portion71of the handle portion17is a rotation shaft of the rotation driving source65. The rotation connection portion71of the handle portion17is fixed to the housing60via the rotation driving source65. The rotation connection portion71of the handle portion17is inserted into the shaft insertion portion51aof the rotation connection portion51of the shaft portion15, whereby the two are connected. The rotation connection portion51of the shaft portion15and the rotation connection portion71of the handle portion17are fixed so as not to be movable relative to each other in a radial direction and a circumferential direction, but are not fixed in an axial direction. That is, these portions are connected in a state of not being locked to each other.

The fluid connection portion52of the shaft portion15includes a cylindrical insertion portion52a, and an O-ring52bis attached to a distal portion thereof. The handle portion17includes a fluid connection portion72which is connected to the fluid connection portion52of the shaft portion15. The fluid connection portion72of the handle portion17is fixed to the housing60. The fluid connection portion72of the handle portion17includes a connector portion72athat accommodates the insertion portion52aof the fluid connection portion52of the shaft portion15. The connector portion72aincludes a latch portion72bthat latches the fluid connection portion52of the shaft portion15. An inner surface of the connector portion72ahas a slightly small diameter on a distal side of the latch portion72b, and the O-ring52bof the insertion portion52aclimbs over the small diameter portion and is elastically latched to the latch portion72b. Accordingly, the fluid connection portion52of the shaft portion15is locked and connected to the fluid connection portion72of the handle portion17.

A connection structure between the rotation connection portion51of the shaft portion15and the rotation connection portion71of the handle portion17is different from a connection structure between the fluid connection portion52of the shaft portion15and the fluid connection portion72of the handle portion17. In addition, the rotation connection portion51of the shaft portion15and the rotation connection portion71of the handle portion17are connected in a state of not being locked to each other, and the fluid connection portion52of the shaft portion15and the fluid connection portion72of the handle portion17are locked and connected to each other. Therefore, when a lock on an aspiration side is released, connection on a rotation side is also easily released. Accordingly, even when aspiration cannot be performed during a procedure, rotation can be immediately stopped so as not to increase the number of the cut objects in the blood vessel.

The connector portion72ais made of a resin material, and axial front and rear portions of the latch portion72bare a deformable portion72cthat is elastically deformable in a radial direction. Therefore, when the operator presses, in the radial direction, the deformable portion72cwith a finger so as to deform the deformable portion72c, the deformable portion72cis elastically deformed, and a latch state of the insertion portion52awith respect to the latch portion72bis released accordingly. Therefore, the fluid connection portion52of the shaft portion15can be easily removed from the connector portion72a. On the other hand, if the operator does not intentionally deform the deformable portion72c, the latch state of the insertion portion52awith respect to the latch portion72bis maintained, and thus it is possible to prevent the fluid connection portion52of the shaft portion15from being unexpectedly detached from the fluid connection portion72of the handle portion17.

Since the rotation connection portion71of the handle portion17and the fluid connection portion72of the handle portion are both fixed to the housing60of the handle portion17, positions of the rotation connection portion71and the fluid connection portion72are fixed. As described above, the rotation connection portion51of the shaft portion15and the fluid connection portion52of the shaft portion15are also fixed. Therefore, by accommodating the connection portion50of the shaft portion15in the accommodation portion63of the handle portion17, the rotation connection portion51of the shaft portion15can be connected to the rotation connection portion71of the handle portion17, and the fluid connection portion52of the shaft portion15can be connected to the fluid connection portion72of the handle portion17.

As shown inFIG.5, the connector portion72acan be slightly deformed so as to tilt the axial direction with respect to the housing60. On the other hand, in order to rotationally drive the drive shaft20, the rotation connection portion71of the handle portion17provided on the rotation driving source65is fixed so as not to tilt the axial direction. Therefore, the drive shaft20can be stably rotationally driven, and even if a dimensional error occurs in a positional relationship between the rotation connection portion51of the shaft portion and the fluid connection portion52of the shaft portion, these connection portions can be reliably connected to the handle portion17.

In the handle portion17, the rotation driving source65, the fluid driving source66, and the power supply portion67are disposed in this order from the distal side toward the proximal side. These portions are disposed such that central axes thereof are substantially coaxial. Accordingly, gravity center positions of the rotation driving source65, the fluid driving source66, and the power supply portion67can be arranged substantially in a straight line along a longitudinal direction of the handle portion17, so that the operator can easily operate the shaft portion15while holding the handle portion17.

A pump main body80of the fluid driving source66has an injection port81as an inlet and a discharge port82as an outlet. An injection tube85extending from the fluid connection portion72of the handle portion17is connected to the injection port81. A discharge tube86is connected to the discharge port82. The discharge tube86is drawn out to an outside of the housing60. A part or all of a portion of the discharge tube86drawn out to the outside of the housing60is transparent or translucent. Accordingly, the operator can visually recognize an inside of the discharge tube86. It is noted that a portion of the discharge tube86disposed inside the housing60may or may not be transparent or translucent. The discharge tube86is connected to a collection bag (not shown) outside the handle portion17.

As shown inFIG.6, a central axis66aof the fluid driving source66is tilted at an angle α with respect to a rotation axis65aof the rotation driving source65. Accordingly, a length of the fluid driving source66in the longitudinal direction connecting a proximal end and a distal end of the handle portion17can be reduced, and the handle portion17can be shortened, so that the operator can easily operate the handle portion17.

As shown inFIG.7A, the fluid driving source66includes a driving portion83and an inner tube84inside the pump main body80having the injection port81and the discharge port82. The pump main body80includes a wall portion80atherein, and the inner tube84is disposed along the wall portion80a. The driving portion83is driven by a motor and rotatable at a center portion, and includes, in a circumferential direction, a plurality of pressing portions83aprotruding in a radial direction from the center portion.

The inner tube84communicates with the lumen22, and is disposed over approximately 270° so as to surround the driving portion83. An outer peripheral portion of each pressing portion83aof the driving portion83is in pressure contact with the inner tube84. The pressing portions83amove in the circumferential direction while deforming the inner tube84at a plurality of positions between the pressing portions83aand the wall portion80a. A portion of the inner tube84is pressed by the pressing portions83aof the driving portion83, but an inner flow path is not completely closed, and a communicating region remains. As shown inFIG.7BandFIG.7C, the fluid in the inner tube84indicated by hatching in the drawings moves toward the discharge port82side in accordance with the rotation of the driving portion83. Accordingly, the fluid inside the inner tube84is conveyed in a certain direction from the injection port81toward the discharge port82.

In this way, by using a pump that acts from an outer surface of the inner tube84to convey the fluid inside the inner tube84as the fluid driving source66, even if the fluid aspirated into the shaft portion15or the inner tube84contains a hard calcareous fragment, a plaque, and the like, the objects do not come into direct contact with the driving portion83, and therefore, it is possible to prevent an operation from being stopped due to the fragment, the plaque, and the like being caught in the driving portion83. Accordingly, even when the fluid containing the object cut by the cutting portion40is aspirated by the fluid driving source66, the fluid driving source66can be prevented from being stopped. The inner tube84of the fluid driving source66is made of a material capable of EO sterilization or a material capable of electron beam sterilization. Examples of such a material include a pharmed BPT and a silicon tube. However, the inner tube84may be made of a material other than these materials. As for bending strength related to difficulty of kinking a tube or resistance of an inner diameter to be crushed, it is desirable that the injection tube85is larger than the inner tube84and the discharge tube86is larger than the injection tube85. The injection tube85and the discharge tube86are made of a material which is thicker than the inner tube84and is hardly broken. In addition, a blade may be wound around a tube body of the injection tube85and the discharge tube86. Since a negative pressure is applied to an inside of the injection tube85, a kink occurs and the aspiration cannot be performed, and thus high bending strength is required. In the discharge tube86, when the kink occurs, the aspirated object cannot reach the collection bag, and the discharge tube86may be damaged due to an increase in an internal pressure, and thus higher bending strength is required. Since the inner tube84is a tube having small bending strength and a small thickness, the inner tube84is easily deformed by the driving portion83, and the fluid inside the inner tube84can be easily moved. However, the inner tube84, the injection tube85, and the discharge tube86may have the same bending strength. In addition, a diameter and the material for the inner tube84can be changed according to other components such as the driving portion83and the fluid driving source66to be used.

When the fluid driving source66in which the inner tube84is disposed so as to surround a periphery of the driving portion83by 180° is used, the injection port81and the discharge port82can be disposed on both sides of the pump main body80. In such a case, as shown inFIG.8, an angle α between the central axis66aof the fluid driving source66and a direction of the rotation axis65aof the rotation driving source65can be set to 90°. The injection tube85and the discharge tube86which are connected to the fluid driving source66are arranged substantially in a straight line inside the handle portion17. Accordingly, space efficiency inside the handle portion17can be further improved, and the handle portion17can be miniaturized. In addition, since the injection tube85protrudes from a side surface of the fluid driving source66, the injection tube85is disposed at a position away from a central axis of the housing60. Similarly, since the fluid connection portion52of the shaft portion15is located at a position away from the central axis of the housing60, the injection tube85and the fluid connection portion52of the shaft portion15are arranged substantially in a straight line. Accordingly, the fluid driving source66can easily aspirate the fluid. In addition, the injection tube85is arranged in parallel near the rotation driving source65. Accordingly, blood or the like moving in the injection tube85and the injection tube85can cool the rotation driving source65. In addition, the fluid driving source66, which is larger than the rotation driving source65, is located on a proximal side of the rotation driving source65. Accordingly, a circumferential length of an outer surface of the housing60can be shortened from the proximal side toward the distal side, and the housing60can be formed into a shape that can be easily gripped by the operator. Examples of the fluid driving source66include an aspiration pump, a screw pump, and a peristaltic pump which generate a negative pressure from an outside.

As shown inFIG.6, a control board68is further disposed inside the handle portion17. The control board68is connected to the power supply portion67, and includes a control circuit (not shown) that controls the rotation driving source65and the fluid driving source66based on the operation of the operation switch61. The control board68is disposed so as to extend from a side portion of the rotation driving source65to a side portion of the fluid driving source66, and is slightly inclined with respect to the longitudinal direction of the handle portion17. Accordingly, the space efficiency of the control board68inside the handle portion17is improved. In addition, the control board68includes a light emitting portion68aat a position on a distal side thereof. The light emitting portion68aindicates operation states of the rotation driving source65and the fluid driving source66or an alert or the like as necessary. By disposing the light emitting portion68aat this position, the light emitting portion68ais disposed in a gap between an index finger and a thumb when the operator holds the handle portion17with a hand, and thus the operator can easily visually recognize the light emitting portion68a.

In the above example, the rotation driving source65and the fluid driving source66are connected to the control board68and driven by the single power supply portion67, but the rotation driving source65and the fluid driving source66may be controlled by independent circuits and include the respective power supply portions67. Accordingly, it is possible to prevent one from being affected by a current or voltage change due to an operation of the other. In addition, the control board68is located at a side opposite the injection tube85. Accordingly, a space is secured around the injection tube85, and the injection tube85can be disposed substantially in a straight line.

FIG.9shows a modified handle portion18. As shown inFIG.9, the rotation driving source65and the fluid driving source66may be arranged in parallel along a direction orthogonal to a longitudinal direction connecting a distal end and a proximal end of the handle portion18. Accordingly, a length of the handle portion18can be shortened. When the length of the handle portion18is short, usability of the handle portion18is improved, and the operator can more easily operate the handle portion18.

In addition, the power supply portion67may be disposed radially outside the rotation driving source65and the fluid driving source66inside the handle portion18. Accordingly, the rotation driving source65, the fluid driving source66, and the power supply portion67, which are heavy, are all located in the hand of the operator, so that a gravity center position of the handle portion18is positioned at a center of the hand that grips the handle portion18, and the handlability can be further improved.

With respect to a positional relationship between the rotation connection portion51of the shaft portion15and the fluid connection portion52of the shaft portion15in a direction of inserting into the handle portion17(or18), it is desirable that the rotation connection portion51of the shaft portion15is not connected to the rotation connection portion71of the handle portion17in a state where the fluid connection portion52of the shaft portion is not correctly connected to the fluid connection portion72of the handle portion17. With such a positional relationship, it is possible to prevent the drive shaft20from starting to rotate without starting to aspirate the fluid.

As a positional relationship for this, as shown inFIG.10, the rotation connection portion51of the shaft portion15can be disposed such that a proximal position thereof is located on the distal side or at the same position as a proximal position of the fluid connection portion52of the shaft portion15. In the shaft insertion portion51aof the rotation connection portion51of the shaft portion15, a shaft insertion portion51aincluding a fitting gear portion51bformed on an inner surface thereof is fitted to a gear portion71aformed on a surface of the rotation connection portion71on the handle portion side. According to the positional relationship inFIG.10, the fitting gear portion51bcan be prevented from being fitted to the gear portion71aof the rotation connection portion71of the handle portion17until the fluid connection portion52of the shaft portion is connected to and locked by the fluid connection portion72of the handle portion, and the rotation connection portion can be prevented from being rotatably connected unless the fluid connection portions are connected.

In addition, as shown inFIG.11, when the proximal position of the rotation connection portion51of the shaft portion15is located on the proximal side with respect to the proximal position of the fluid connection portion52of the shaft portion15, the fitting gear portion51bformed on the inner surface of the shaft insertion portion51amay be formed only on a distal side of the shaft insertion portion51awithout being formed on a proximal side of the shaft insertion portion51a. Since the gear portion71aof the rotation connection portion71of the handle portion can be inserted into the proximal side of the shaft insertion portion51abut is not fitted thereto, the fitting gear portion51bcan be prevented from being fitted to the gear portion71aof the rotation connection portion71of the handle portion17until the fluid connection portion52of the shaft portion15is connected to and locked by the fluid connection portion72of the handle portion17. Accordingly, the rotation connection portion can be prevented from being rotatably connected unless the fluid connection portions are connected.

In a positional relationship ofFIG.11, the gear portion71aformed in the rotation connection portion71of the handle portion17may be formed only on a distal side of the rotation connection portion71of the handle portion17. In addition, when the fitting gear portion51bis formed on the entire rotation connection portion51of the shaft portion15, the gear portion71amay be formed only on a proximal side of the rotation connection portion71of the handle portion17.

In addition, although the rotation connection portion51of the shaft portion15and the rotation connection portion71of the handle portion17are fixed to each other by a gear structure, magnets may be provided on both of the connection portions so that the connection portions are easily connected to each other.

As described above, the medical device10includes: the long shaft portion15that includes the drive shaft20and the lumen22; the cutting portion40that is disposed at a distal portion of the shaft portion15and cuts the object; and the handle portion17that is disposed at the proximal portion of the shaft portion15, in which the handle portion17accommodates the rotation driving source65that rotates the drive shaft20, and the fluid driving source66that moves the fluid from the distal side to the proximal side of the lumen22, and the fluid driving source66includes a flow path portion84that communicates with the lumen22, and the driving portion83that conveys the fluid in the flow path portion84in one direction. In the medical device10configured as described above, since the driving portion83acts to convey the fluid, even if the fluid aspirated into the shaft portion15or the inner tube84contains a calcareous fragment, a plaque, and the like, the driving portion83conveys them by a mechanical pressing force, and thus it is possible to prevent the driving portion83from being stopped during the cutting and aspiration procedure in which the shaft portion15is inserted into a living body. It is noted that the aspiration means that the fluid is drawn from an outside to an inside of the shaft portion or the inner tube and the fluid is moved in the shaft portion or the inner tube. In addition, the conveyance means that the fluid is moved in the shaft portion or the inner tube by the mechanical pressing force.

In addition, in the medical device10, the fluid driving source66may include the inner tube84as a flow path portion and the driving portion83that acts on the fluid inside the inner tube84from the outer surface of the inner tube84. Accordingly, since the driving portion83acts to convey the fluid, even if the fluid aspirated into the shaft portion15or the inner tube84contains a calcareous fragment, a plaque, and the like, the objects do not come into direct contact with the driving portion83, and thus it is possible to prevent the driving portion83from being stopped during the cutting and aspiration procedure in which the shaft portion15is inserted into the living body.

In addition, the medical device10includes: the long shaft portion15that includes the drive shaft20and the lumen22; the cutting portion40that is disposed at the distal portion of the shaft portion15and cuts the object; and the handle portion17that is disposed at the proximal portion of the shaft portion15, in which the handle portion17accommodates the rotation driving source65that rotates the drive shaft20, and the fluid driving source66that moves the fluid from the distal side to the proximal side of the lumen22, the rotation driving source65has the rotation axis65a, and the central axis of the fluid drive source66has an angle with the rotation axis65a. In the medical device10configured as described above, the space efficiency of the fluid driving source66in the handle portion17can be improved, the handle portion17can be shortened to allow the operator to easily operate the handle portion17, and handling of the injection tube85connected to the fluid driving source66in the handle portion17can be simplified.

In addition, the medical device10includes: the long shaft portion15that includes the drive shaft20and the lumen22; the cutting portion40that is disposed at the distal portion of the shaft portion15and cuts the object; and the handle portion17that is disposed at the proximal portion of the shaft portion15, in which the handle portion17includes the rotation driving source65that rotates the drive shaft20, the fluid driving source66that moves the fluid from the distal side to the proximal side of the lumen22, and the power supply portion67that is connected to the rotation driving source65and the fluid driving source66. In the medical device10configured as described above, operability of the handle portion17can be improved by omitting a power cable extending from the handle portion17to the outside.

In addition, the medical device10includes: the long shaft portion15that includes the drive shaft20and the lumen22; the cutting portion40that is disposed at the distal portion of the shaft portion15and cuts the object; and the handle portion18that is disposed at the proximal portion of the shaft portion15, in which the handle portion18accommodates the rotation driving source65that rotates the drive shaft20, and the fluid driving source66that moves the fluid from the distal side to the proximal side of the lumen22, and the rotation driving source65and the fluid driving source66are arranged in parallel along the direction orthogonal to the longitudinal direction connecting the distal end and the proximal end of the handle portion18. In the medical device10configured as described above, the handle portion18can be shortened, and the gravity center position of the handle portion18can be disposed at the center of the hand of the operator who performs the operation, and thus the operator can easily hold and operate the handle portion18.

In addition, the rotation driving source65and the fluid driving source66may be disposed along the longitudinal direction connecting the distal end and the proximal end of the handle portion17. Accordingly, the gravity center positions of the rotation driving source65and the fluid driving source66can be arranged substantially in a straight line along the longitudinal direction of the handle portion17, so that the operator can easily operate the shaft portion15while holding the handle portion17.

In addition, the handle portion17may include the power supply portion67connected to the rotation driving source65and the fluid driving source66, and the rotation driving source65, the fluid driving source66, and the power supply portion67may be disposed along the longitudinal direction connecting the distal end and the proximal end of the handle portion17. Accordingly, the gravity center position of the power supply portion67can also be arranged substantially in a straight line with the rotation driving source65and the fluid driving source66, and thus the operability of the handle portion17can be further improved.

In addition, the handle portion18may include the power supply portion67connected to the rotation driving source65and the fluid driving source66, and the power supply portion67may be disposed radially outside the rotation driving source65and the fluid driving source66inside the handle portion18. Accordingly, the handle portion18can be shortened in the longitudinal direction, the operator can easily grip the handle portion18, and operability of the handle portion18can be improved.

In addition, the rotation driving source may have the rotation axis65a, and the central axis of the fluid driving source66may have the angle with the rotation axis65a. Accordingly, the space efficiency of the fluid driving source66in the handle portion17can be improved, the handle portion17can be shortened to allow the operator to easily operate the handle portion17, and the handling of the injection tube85connected to the fluid driving source66in the handle portion17can be simplified.

It is noted that the present invention is not limited to the embodiments described above, and various modifications can be made by those skilled in the art within a scope of the technical idea of the present invention. In the above-described embodiments, the connection structure between the rotation connection portion51of the shaft portion15and the rotation connection portion71of the handle portion17is different from the connection structure between the fluid connection portion52of the shaft portion15and the fluid connection portion72of the handle portion17, but those connection structures may be the same. In addition, the rotation connection portion51of the shaft portion15and the rotation connection portion71of the handle portion17are not locked, and the fluid connection portion52of the shaft portion15and the fluid connection portion72of the handle portion17are locked, but both the connection structures may be a locked structure.

In addition, both the connection structure between the rotation connection portion51of the shaft portion15and the rotation connection portion71of the handle portion17and the connection structure between the fluid connection portion52of the shaft portion15and the fluid connection portion72of the handle portion17may not be a locked structure. In such a case, a latch portion or the like for locking is provided on the connection portion50of the shaft portion15and the housing60.

In addition, the rotation connection portion71of the handle portion17and the fluid connection portion72of the handle portion17may be coaxially arranged. In such a case, the rotation connection portion71of the handle portion17is formed in a hollow shape, and the fluid connection portion72of the handle portion17is disposed inside the hollow of the rotation connection portion71of the handle portion17. In addition, the rotation connection portion51of the shaft portion15and the fluid connection portion52of the shaft portion15are also coaxially arranged and connected to the rotation connection portion71of the handle portion17and the fluid connection portion72of the handle portion17, respectively. In addition, the type of the fluid driving source66is not limited to a pump that generates a negative pressure from an outside, and may be a pump such as a diaphragm pump in which a driving portion is in direct contact with a fluid.

In addition, as shown inFIG.12, the rotation driving source65may be disposed such that the central axis thereof is disposed at a position away from the central axis of the fluid driving source66. Accordingly, a terminal of the rotation driving source65is separated from the fluid driving source66, and electromagnetic noise can be reduced.

In addition, a pump shown inFIGS.13A-13Cmay be used as a fluid driving source. As shown inFIG.13A, a fluid driving source90includes an aspiration port91communicating with the lumen22, a flow path portion93communicating with the aspiration port91, and a discharge port92communicating with the flow path portion93. The flow path portion93is provided with a driving portion94having an elliptical cross section. A seal member95biased by an elastic pressing body96is in contact with the driving portion94. The seal member95constantly contacts a surface of the driving portion94by the biasing of the elastic pressing body96when the driving portion94is rotated. InFIGS.13A-13C, the fluid is indicated by hatching.

As shown inFIG.13B, when the driving portion94is rotated, the fluid from the aspiration port91enters along a circumferential direction of the flow path portion93. As shown inFIG.13C, when the driving portion94is further rotated, the fluid is pushed out from the flow path portion93to the discharge port92. Since an upper portion of the driving portion94is sealed with the seal member95, the fluid is conveyed in one direction from the aspiration port91toward the discharge port92by the driving portion94. In this way, by using the pump in which the fluid is conveyed in one direction by the driving portion94as the fluid driving source90, even if the fluid aspirated into the shaft portion15or the inner tube84contains the hard calcareous fragment, the plaque, and the like, the objects are conveyed by a mechanical pressing force of the driving portion94compared to a pump that generates a negative pressure to perform aspiration, and thus, clogging inside the fluid driving source90can be prevented.