JP2000201939A - Medical implement - Google Patents

Abstract

PROBLEM TO BE SOLVED: To perform a sophisticated treatment exceeding a mere puncture to an object existing on the reverse side of a mucous membrane in a single operation by forming tip parts of a pair of tip treating members in a sharply pointed shape in the forward direction. SOLUTION: In a pair of tip treating members 6, 7 of a medical implement 1, tip parts are formed in a sharply pointed shape in the forward direction, and in a closed state, both pointed tip parts are contacted with each other to become a single needle tip shape. Thus, for example, a treatment such as gathering a biopsy tissue from a tumor under a mucous membrane can be easily performed in such a way that first of all, a pair of tip treating members 6, 7 are thrust in a tumor existing in the inmost part from a surface of a mucous membrane, the tip treating members 6, 7 are opened, the tip treating member 6, 7 are pushed in the tumor, and are closed. The biopsy tissue from the tumor under the mucous membrane is not only gathered but also a biopsy of a pancreas can be performed from a stomach under an optical observation and an observation of an ultrasonic tomograph by inserting, for example, the treating tool 1 into a implement inserting channel of an ultrasonic endoscope.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

[0001] The present invention relates to a medical treatment tool.

[0002]

2. Description of the Related Art There are various types of medical treatment tools. For example, when a treatment for a submucosal tumor or the like is performed, the surface of the mucosa is first incised with a scalpel, and then the forceps is passed through the incision. It is usual to perform necessary treatment for tumors by inserting such a treatment tool.

However, if the next treatment is performed again after the mucous membrane is cut, it is necessary to make a large incision, and the treatment takes time. Therefore, there is a device in which a needle-shaped puncture device is used to perform a series of operations for puncturing a mucosal surface and collecting cells such as a tumor located behind the mucosal surface.

[0004]

However, the above-mentioned needle-shaped treatment instrument cannot perform a treatment in a range larger than the thickness of the needle, and cannot pinch or grasp the treatment target. And so on.

[0005] Therefore, an object of the present invention is to provide a medical treatment tool capable of performing a high-level treatment beyond a simple puncture on an object behind a mucous membrane or the like by a single operation.

[0006]

In order to achieve the above-mentioned object, a medical treatment instrument of the present invention is provided with a sheath and an axially movable back and forth along the sheath. An operating motion transmitting member, and a pair of distal treatment members disposed at the distal end of the sheath so as to be openable and closable in a beak shape and driven to open and close by an advance / retreat operation of the operating motion transmitting member. Is characterized in that the distal end portion of the distal treatment member is formed in a shape sharply pointed forward.

[0007] When the pair of distal treatment members are closed, it is preferable that both sharp distal ends are brought into contact with each other. Even if the distal treatment member is a biopsy forceps cup or a gripping forceps piece. Good.

The sheath may be flexible and can be inserted into and removed from a treatment instrument insertion channel of an endoscope. May be inserted into and removed from a trocar pierced from the surface of the trocar.

[0009]

Embodiments of the present invention will be described with reference to the drawings. FIG. 1 shows a distal end portion of a treatment tool 1 according to a first embodiment of the present invention, which is a biopsy forceps for collecting a biopsy tissue specimen from under a mucous membrane of a human body.

The elongated sheath 2 is formed of a stainless steel tube or the like when flexibility is not required. When flexibility is required, a coiled pipe or stainless steel wire having a stainless steel thin wire tightly wound with a constant diameter is used. It is formed by a fluorinated ethylene resin tube or the like.

An operation wire 3 is provided at the axial position of the sheath 2.
An operating unit (not shown) in which an (operating motion transmitting member) is inserted through the entire length and connected to the base end of the sheath 2
Is operated.

A forceps cup is attached to a metal distal end body 4 fixed to the distal end of the sheath 2 as a pair of distal end treatment members 6 and 7 that are driven to open and close in a beak shape by the operation wire 3.

A slit 4a is formed in the distal end main body 4 so as to divide the distal end main body 4 into two parts from the front side, and a support shaft 8 is attached to the distal end main body 4 so as to cross the vicinity of the distal end of the slit 4a. Have been.

The pair of distal treatment members 6 and 7 are rotatably supported by the support shaft 8 so as to open and close in a beak shape around the support shaft 8. A known link mechanism 10 driven by the operating wire 3 for operation is arranged in the slit 4a.

The link mechanism 10 includes four links 11
To 14 are formed in a so-called pantograph shape in which the two links 11 and 12 are rotatably connected to each other in a ring shape, and the two links 11 and 12 on the leading side are integrally formed integrally with the pair of distal treatment members 6 and 7. And rotates about the support shaft 8.

The two links 11 and 12 and the connecting shaft 1
The two intermediate links 13 and 14 rotatably connected to each other by 7 and 18 are rotatably connected to the drive rod 15 on the rear end side by a connecting shaft 19.

The distal end of the operation wire 3 is connected and fixed to the drive rod 15, and the link mechanism 10 is operated by remote operation from the near side (right side in FIG. 1) to push the operation wire 3 forward. A pair of distal treatment members 6, 7
Is opened as shown by the two-dot chain line, and the pair of distal treatment members 6 and 7 are closed as shown by the solid line by pulling the operation wire 3 toward the user.

FIG. 2 is a perspective view of one of the pair of distal treatment members 6 and 7 of the medical treatment instrument thus configured.
As shown in FIG. 2, the distal end portions are formed in a sharply pointed shape toward the front, and when the pair of distal end treatment members 6 and 7 are closed, the two distal end portions come into contact with each other and become one. One needle point.

Therefore, for example, in a procedure for collecting a biopsy tissue from a submucosal tumor, first, as shown in FIG.
After piercing the pair of distal treatment members 6 and 7 into each other and opening the pair of distal treatment members 6 and 7 as shown in FIG.
6 can be easily performed by further pushing the pair of distal treatment members 6 and 7 into the tumor 102 and then closing the pair of distal treatment members 6 and 7 as shown in FIG.

In addition to collecting biopsy tissue from a submucosal tumor, as shown in FIG. 7, for example, the treatment tool 1 is passed through a treatment tool insertion channel 51 of an ultrasonic endoscope 50 to be optically illuminated. A biopsy of the pancreas (or liver) 104 and the like can be performed from the stomach 103 under observation and observation of the ultrasonic tomographic image.

As shown in FIG. 8, the treatment instrument 1 of the present invention is inserted into a trocar 61 pierced into the abdominal cavity from the epidermis 105 of the human body, and is passed through another trocar 62. The biopsy of various internal organs 106 can be performed under the observation by.

FIG. 9 shows a distal end portion of a treatment tool 1 according to a second embodiment of the present invention, and a pair of distal treatment members 6 and 7 which open and close like a beak are sharply pointed forward. A crocodile-shaped gripping piece is attached. Other configurations are the same as those of the above-described first embodiment.

In this case, as shown in FIG. 10, for example, the treatment tool 1 is pushed out from the treatment tool insertion channel 71 of the endoscope 70 inserted into the stomach 103 through the stomach wall to protrude into the abdominal cavity, and the trocar 73 Endoscope 74 inserted through
By a joint operation with a treatment tool 77 used from the side, a suturing treatment or the like using the needle 78 and the thread 79 can be performed.

FIG. 11 shows a distal end portion of a treatment tool 1 according to a third embodiment of the present invention, in which a space 9 formed between a pair of distal treatment members 6, 7 is used as a grasping portion. It is a kind of forceps.

As shown in FIG. 12, which shows a cross section taken along the line XII--XII, fang-like projections 6a and 7a that mesh with each other are formed in the middle of the pair of distal treatment members 6 and 7, and a space 9 is formed. It is closed to the outside.

As a result, for example, as shown in FIG. 13, the blood vessel 112 and other organs on the other side of the stomach wall 111 are tightened by the treatment tool 1 protruding from the treatment tool insertion channel 81 of the endoscope 80. Can be held loosely.

As described above, the present invention can be applied to various treatment tools having a tip treatment member that can be opened and closed like a beak.
In particular, the effect of application to an endoscope that is inserted into a treatment instrument insertion channel is significant.

[0028]

According to the present invention, by forming the distal end portion of the distal treatment member into a sharp pointed shape toward the front, a high degree of treatment beyond mere puncture to an object behind the mucous membrane or the like is achieved. Can be performed by a single operation, which can greatly contribute to facilitation of various procedures including surgery.

[Brief description of the drawings]

FIG. 1 is a side sectional view of a distal end portion of a medical treatment tool according to a first embodiment of the present invention.

FIG. 2 is a perspective view of a distal treatment member according to the first embodiment of the present invention.

FIG. 3 is a schematic sectional view showing the operation of the medical treatment tool according to the first embodiment of the present invention.

FIG. 4 is a schematic sectional view showing the operation of the medical treatment tool according to the first embodiment of the present invention.

FIG. 5 is a schematic sectional view showing the operation of the medical treatment tool according to the first embodiment of the present invention.

FIG. 6 is a schematic sectional view showing the operation of the medical treatment tool according to the first embodiment of the present invention.

FIG. 7 is a schematic view showing an example of use of the medical treatment tool according to the first embodiment of the present invention.

FIG. 8 is a schematic view showing a second use example of the medical treatment tool according to the first embodiment of the present invention.

FIG. 9 is a side sectional view of a distal end portion of a medical treatment tool according to a second embodiment of the present invention.

FIG. 10 is a schematic view showing a usage example of the medical treatment tool according to the second embodiment of the present invention.

FIG. 11 is a side sectional view of a distal end portion of a medical treatment tool according to a third embodiment of the present invention.

FIG. 12 shows a third embodiment of the present invention in FIG.
It is XII-XII sectional drawing.

FIG. 13 is a schematic view showing a usage example of the medical treatment tool according to the third embodiment of the present invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Treatment tool 2 Sheath 3 Operation wire (operation movement transmission member) 6, 7 A pair of distal treatment members 8 Support shaft 10 Link mechanism

Claims (5)

[Claims] An operating motion transmitting member which is disposed along the sheath so as to be able to advance and retreat in the axial direction and which advances and retreats by an operation from a hand side, and which is arranged at a tip end of the sheath so as to be openable and closable in a beak shape. In a medical treatment tool having a pair of distal treatment members that are driven to open and close by an advancement and retreat operation of the operation motion transmitting member, the distal end portions of the pair of distal treatment members are formed to have a sharply pointed shape toward the front. A medical treatment tool characterized by the above-mentioned. 2. The medical treatment tool according to claim 1, wherein when the pair of distal treatment members are closed, both sharp distal end portions are in contact with each other. 3. The medical treatment tool according to claim 1, wherein the distal treatment member is a biopsy forceps cup or a grasping forceps piece. 4. The medical treatment tool according to claim 1, wherein the sheath has flexibility and is inserted into and removed from a treatment tool insertion channel of an endoscope. 5. The medical treatment tool according to claim 1, wherein the sheath has rigidity and is inserted into and removed from a trocar pierced from the surface of a human body.