JP4043456B2 - High frequency incision tool - Google Patents

Description

  The present invention relates to a high-frequency incision instrument that is inserted into a body through an endoscope and performs high-frequency incision of an affected area.

  In general, a conductive knife wire is exposed at the distal end of an insertion portion such as an elongated flexible tube as a kind of endoscopic treatment tool inserted into the body through an endoscope, and a high frequency is applied to the knife wire. A configuration in which an incision of an affected part is performed is known. Examples of this type of endoscope treatment tool include those disclosed in Patent Document 1 and Patent Document 2.

  Here, Patent Document 1 is provided with an outer sheath through which the treatment instrument main body is inserted so as to freely advance and retract. Then, the length of the knife wire exposed to the outside of the outer sheath sheath is changed by moving the outer sheath sheath forward and backward in the axial direction with respect to the treatment instrument body.

Patent Document 2 discloses a configuration in which conductive Teflon (registered trademark) is coated on the surface of a conductive knife wire exposed at the distal end of the insertion portion.
JP-A-5-176940 Japanese Patent Laid-Open No. 4-307055

  By the way, when performing EST (duodenal papilla sphincter resection) using a knife wire, the following operation is performed. After setting the distal end portion of the insertion portion of the endoscope previously inserted into the patient's body close to the nipple, the insertion portion of the endoscope treatment tool is inserted into the body through the treatment tool insertion channel of the endoscope. Inserted. Then, the distal end portion of the insertion portion of the treatment instrument that protrudes to the outside of the endoscope through the forceps opening of the endoscope is inserted into the bile duct transpapillary. In this state, a high-frequency current is applied to the knife wire, and the nipple sphincter is excised.

  Further, when performing the EST with the treatment tool of Patent Document 1, if the main body of the endoscope or the tissue around the nipple is in contact with the knife wire, while viewing the video of the endoscope to prevent this, An operation for moving the outer sheath is required. However, since the operation of moving the mantle sheath is performed in a state where the distal end of the tube of the treatment instrument body is inserted into the bile duct trans-papillarily, the tube of the treatment instrument main body is connected to the bile duct when the operation of moving the mantle sheath is performed. And there is a problem that increases the possibility of falling out of the nipple.

  Further, since the nipple is disposed in a position near the nipple, for example, in a diverticulum case or the like, the nipple is located deeper than the surrounding tissue. In such a case, a long knife length may be advantageous in order to match the direction of travel of the bile duct with the direction of the tube and knife of the treatment tool body. There is a risk of damaging tissue around the nipple that is not the target part. Furthermore, in this state, since the knife wire is in contact with many living tissues, the current density at the target site is low, and nipple incision becomes difficult.

  Further, in the treatment instrument of Patent Document 1, means for operating the direction and shape of the tube tip of the treatment instrument body using an operation wire is introduced. However, in addition to the operation of the outer sheath and the operation of the knife wire, it is very difficult to simultaneously operate the operation wire for changing the direction of the tube tip of the treatment instrument body.

  Moreover, although the treatment tool of Patent Document 2 can prevent the knife wire from adhering to the contact tissue, it is impossible to prevent the knife wire from contacting a living tissue other than the target site.

  The present invention has been made paying attention to the above circumstances, and an object thereof is to provide a high-frequency incision tool that can improve the safety and operability of EST (duodenal papillary sphincter resection).

According to the first aspect of the present invention, a tube-like flexible insertion portion that is inserted into the body through an endoscope , an opening portion that is disposed at a distal end portion of the insertion portion and communicates with the insertion portion, and can be advanced and retracted into the insertion portion. An operation wire disposed on the distal end of the operation wire, and a wire-like conductive knife extending from the opening to the outside of the insertion portion, and exposed to the outside of the insertion portion A high frequency device comprising: a portion located on the hand side of the knife portion; and an incision portion formed of a portion exposed to the outside of the knife portion; and an insulating coating made of a fluororesin colored in a different color. An incision tool.

The invention of claim 2 is characterized in that the insulating coating is formed by coating a part of the outer surface of the knife part with a fluororesin material colored in a color different from the color of the knife part itself. 1. A high-frequency incision tool according to 1.

  According to the present invention, the safety and operability of EST (duodenal papillary sphincter resection) can be improved.

  In the following, a first embodiment of the present invention will be described with reference to FIGS. The endoscope treatment tool 1 according to the present embodiment includes an elongated insertion portion 3 inserted into the body through an endoscope 2 (see FIG. 5), and a proximal side connected to the proximal end portion of the insertion portion 3. An operation unit 4 is provided.

  Moreover, the main body 3a of the insertion portion 3 of the treatment instrument 1 is formed by a three-lumen tube having three lumens 5a, 5b, and 5c in one tube as shown in FIG. Here, the three lumens in the three-lumen tube, that is, the first lumen 5a, the second lumen 5b, and the third lumen 5c are formed to have different lumen diameters (inner diameter dimensions).

  In the present embodiment, the lumen diameter d1 of the first lumen 5a, the lumen diameter d2 of the second lumen 5b, and the lumen diameter d3 of the third lumen 5c are set in a relationship of d1 <d3 <d2. ing. A conductive knife wire (operation wire) 6 to be described later is inserted into the first lumen 5a having the smallest lumen diameter. However, the insertion portion main body 3a is not limited to the above three-lumen tube, and any tube having one or more lumens 5 may be used.

  Further, as shown in FIG. 1A, a thin diameter portion 3a2 having a smaller outer diameter than the large diameter portion 3a1 on the proximal end side is formed at the distal end portion of the insertion portion main body 3a. In addition, the outer diameter dimension of the insertion part main body 3a may have the same diameter in a full length, or a gentle taper.

  Further, a part of the knife wire 6 is exposed at the distal end portion of the small diameter portion 3a2 in the insertion portion main body 3a. Here, as shown in FIG. 3, two slits (openings) 7a and 7b that are spaced apart from each other are formed at the tip of the small diameter portion 3a2. The tip of the knife wire 6 inserted into the first lumen 5a is exposed to the outside through the front and rear slits 7a and 7b, and is exposed to the outside of the insertion portion main body 3a between the front and rear slits 7a and 7b. ing.

  In addition, a knife tip 8 that is a locking tool is connected to the tip of the knife wire 6. The tip of the knife wire 6 is fixed by pressing the knife tip 8 into the first lumen 5a through the front slit 7a. The fixing position of the knife tip 8 is not limited to this.

  Further, as shown in FIG. 1A, the exposed portion of the entire length Y of the knife wire 6 exposed at the distal end portion of the insertion portion 3 has an incision portion (knife portion) that is not insulated within a range X of 5 to 15 mm from the distal end. ) 9 is formed. Furthermore, an insulating part 10 is provided at a portion of the exposed part of the knife wire 6 except for the incision part 9.

  This insulating portion 10 is formed by coating a PFA fluororesin coating (insulating coating) 11 on the outer peripheral surface of the wire of the knife wire 6 for the purpose of insulation. In addition, the coating 11 is not limited to the said fluorine resin. For example, polytetrafluoroethylene (PTFE), tetrafluoroethylene hexafluoropropylene resin (FEP), polyethylene, polyolefin, polyamide, vinyl chloride, latex, natural rubber, polysulfone, polyphenylsulfone, polyetherimide, POM , PEEK, polycarbonate, ABS, or a synthetic resin material thereof may be used.

  The incision 9 in the exposed portion of the knife wire 6 is energized with a high frequency so that the living tissue in the affected area is incised. In addition, you may make it the structure which attaches colors, such as blue, white, and green, to the coating 11 so that the incision part 9 in the exposed part of the knife wire 6 and the coating 11 of the insulation part 10 can be identified.

  The proximal end portion of the knife wire 6 passes through the first lumen 5a in the insertion portion 3 and extends toward the operation portion 4 side. FIG. 1B shows the operation unit 4 of the endoscope treatment tool 1 according to the present embodiment.

  As shown in FIG. 1B, the operation unit 4 is provided with a substantially rod-shaped main body 12 and a slider 13 slidable in the axial direction along the main body 12. Further, a scale 14 serving as an index for confirming the movement amount of the slider 13 is displayed on the main body 12 of the operation unit 4.

  In addition, the base end of the knife wire 6 is connected to the slider 13. The knife wire 6 can be pulled by pulling the slider 13 to the rear end side.

  FIG. 4 shows an example of a connection method between the proximal end portion of the insertion portion 3 and the operation portion 4. Here, a pressing member 15 is provided at a connecting end portion of the operation portion 4 with the insertion portion 3. A connecting tube 16 made of a single lumen is connected to the pressing member 15.

  Further, a heat shrinkable tube 17 is provided at the connecting portion between the insertion portion 3 and the operation portion 4. Then, in the heat shrinkable tube 17, the base end portion of the main body 3a (three lumen tube) of the insertion portion 3 and the distal end portion of the connecting tube 16 are respectively inserted and abutted against each other. Both are connected by contraction. The heat shrinkable tube 17 may be provided with an adhesive.

  Further, a guide wire cock 18 and a liquid feeding cock 19 are provided in the vicinity of the connecting portion with the operation portion 4 at the proximal end portion of the insertion portion 3. Here, the guide wire cock 18 is connected to the second lumen 5b, and the liquid feeding cock 19 is connected to the third lumen 5c. Each of the guide wire cock 18 and the liquid feeding cock 19 is connected to the proximal end portion of the insertion portion 3 by a heat shrinkable tube 17.

  Note that letters or illustrations may be written on the outer peripheral surface of the guide wire cock 18 and the outer peripheral surface of the liquid feeding cock 19 so that the respective types can be distinguished.

  Next, the operation of the above configuration will be described. FIG. 5 shows a state in which, for example, EST (duodenal papillary sphincter resection) is performed using the endoscope treatment tool 1 of the present embodiment. In FIG. 5, H1 is a bile duct and H2 is a pancreatic duct.

  When this EST treatment is performed, the following operation is performed. After the distal end portion of the insertion portion of the endoscope 2 inserted in the patient's body in advance is set close to the nipple H3, the endoscope treatment tool 1 is passed through the treatment tool insertion channel of the endoscope 2. The insertion part 3 is inserted into the body. Then, the distal end portion of the insertion portion 3 of the treatment instrument 1 protruding to the outside of the endoscope 2 through the forceps opening of the endoscope 2 is inserted into the bile duct H1 transpapillarily. In this state, only the incision 9 of the knife wire 6 is energized with a high-frequency current, and the nipple sphincter is excised.

  Therefore, the above configuration has the following effects. That is, in the present embodiment, an incision portion 9 that is not insulated is provided within a range of 5 to 15 mm from the distal end of the exposed portion of the knife wire 6 exposed at the distal end portion of the insertion portion 3 of the endoscope treatment tool 1. Since the insulated portion 10 is provided in the portion excluding the incision portion 9, the knife exposed at the distal end portion of the insertion portion 3 when performing the EST treatment using the endoscope treatment tool 1. A high-frequency current flows only through the incision portion 9 in the range X of 5 to 15 mm from the tip of the exposed portion of the entire length Y of the wire 6, and the high-frequency current flows in the insulating portion 10 of the exposed portion of the knife wire 6 except for the incision portion 9 It is held in a state where no current flows. Therefore, on the exposed portion of the knife wire 6, it is possible to provide a knife function that can be partially incised only within a range X of 5 to 15 mm from the tip of the exposed portion of the knife wire 6. Only the thickness of H3 can be incised, and damage to other tissues around the nipple and the endoscope 2 can be prevented to the limit. Therefore, it is possible to perform EST safely and reliably with respect to conventional EST difficult cases, and it is possible to improve the transpapillary bile duct insertion performance of the insertion portion 3 of the endoscope treatment tool 1.

  Moreover, since the knife function part of the incision part 9 of the exposed part of the knife wire 6 is short in length and the part in contact with the living tissue is small, the current density of the high-frequency current is increased, and the incision can be reliably performed. It becomes possible.

  Further, by using the end face of the coating 11 on the exposed portion of the knife wire 6 as an index, it is possible to easily measure the insertion depth of the knife wire 6 of the endoscope treatment tool 1 into the nipple H3. .

  In general, the thickness of the human papillary sphincter is around 10 mm, and considering incision methods such as a large incision (cut the nipple in the hole diameter direction) and a small incision (cut the nipple in the hole diameter direction). However, the function of the knife may be about 5 to 15 mm at the tip of the exposed portion of the knife wire 6. However, when performing EST, in order to match the traveling direction of the bile duct H1 and the position of the knife wire 6, the length of the exposed portion of the knife wire 6 exposed to the outside of the insertion portion main body 3a of the treatment instrument 1 is 20 mm. About 35 mm is required.

  Here, when the length of the exposed portion of the knife wire 6 is short, the insertion portion when the knife wire 6 is pulled and the distal end portion of the insertion portion main body 3a is bent in an arcuate shape as shown in FIG. The bending of the tip of the main body 3a becomes tight (large), and the shape does not match the direction of travel with the bile duct H1. However, as the exposed length of the knife wire 6 is longer, there is a risk of damaging a living tissue other than the target site on the hand side of the knife wire 6 or coming into contact with the endoscope 2 and damaging the endoscope 2. There is a problem that increases. Furthermore, in a state where the proximal portion of the knife wire 6 is in contact with a living tissue other than the target site, the current density of the high-frequency current at the target site is reduced, so that the incision cannot be performed well.

  Therefore, according to the endoscope treatment tool 1 having the configuration of the present embodiment, the above-mentioned danger can be prevented, so that EST can be performed safely and reliably, and even for doctors with little experience. You can do EST with your heart.

  6 to 8 (A) to 8 (C) show a second embodiment of the present invention. This embodiment is a substantially wire-shaped pre-curve stylet (used in combination with the endoscope treatment instrument 1 of the first embodiment (see FIGS. 1A, 1B to 5)). (Core metal) 21 is provided. The pre-curve stylet 21 is provided with two curved (R) portions 22 and 23 having different radii of curvature as shown in FIG.

  Here, the first curved portion 22 is disposed on the front end side of the pre-curve stylet 21, and the second curved portion 23 is disposed on the rear end side. The first curved portion 22 has a radius r1 of, for example, 20 ± 5 mm and an opening angle θ1 of about 210 ± 20 °. Furthermore, the radius r2 of the second curved portion 23 is set to 60 ± 10 mm, for example, and the opening angle θ2 is set to about 120 ± 20 °.

  Further, the pre-curve stylet 21 of the present embodiment is formed with a bent portion 24 that is bent at a substantially right angle toward the inward direction of bending at the distal end portion of the first bending portion 22. The length L of the bent portion 24 is set to about 5 ± 1 mm, for example. Further, the difference (gap) between the outer diameter dimension of the pre-curve stylet 21 and the inner diameter dimension of the lumen 5 of the insertion portion main body 3a of the endoscope treatment tool 1 into which the pre-curve stylet 21 is inserted is 0. It is set to about 3 mm or less. Note that the pre-curve stylet 21 of the present embodiment is formed of a metal material such as stainless steel or a resin material.

  Next, the operation of the above configuration will be described. When the endoscope treatment tool 1 according to the present embodiment is used, the pre-curve stylet 21 is inserted into the lumen 5 of the insertion portion main body 3a for a certain period of time as shown in FIG. At this time, the pre-curve stylet 21 is inserted into the lumen 5 of the insertion portion main body 3a of the endoscope treatment tool 1 for a predetermined time, so that the pre-curve stylet is inserted into the insertion portion main body 3a of the endoscope treatment tool 1. 21, that is, two curved curved lines adapted to the respective shapes of the first curved part 22 on the front end side and the second curved part 23 on the rear end side of the pre-curve stylet 21. 22a and 23a can be attached.

  As described above, in the present embodiment, since the bending portion 22a, 23a having two different curved shapes can be formed on the insertion portion main body 3a of the endoscope treatment tool 1, FIGS. ), The length of the insertion portion main body 3a of the endoscope treatment instrument 1 protruding from the distal end of the endoscope 2 is adjusted so that the distal end of the insertion portion main body 3a of the endoscope treatment instrument 1 is adjusted. It is possible to variously adjust the direction in which it faces and the shape of the insertion portion main body 3a of the endoscope treatment tool 1. For this reason, it is easy to adjust to a shape suitable for the shape of the nipple opening having various shapes and the bile duct shape.

  8A to 8C show a state in which the EST is performed using the endoscope treatment tool 1 of the present embodiment with the pre-curve stylet 5 removed from the insertion portion 3. Is shown. Here, FIG. 8A shows an approach method of the insertion portion main body 3a of the endoscope treatment tool 1 to the nipple H3 in a general nipple-shaped case.

  FIG. 8B shows an approach method of the insertion portion main body 3a of the endoscope treatment tool 1 to the nipple H3 in a case where the upper portion of the nipple H3 hangs down. Further, FIG. 8C shows an approach method of the insertion portion main body 3a of the endoscope treatment tool 1 to the nipple H3 in a case where the endoscope 2 cannot approach the nipple H3, such as a diverticulum case.

  Therefore, in the case of the above configuration, the first bending portion 22 and the rear end side of the pre-curve stylet 21 can be easily added to the insertion portion main body 3a of the endoscope treatment tool 1 without particularly requiring heat treatment. It is possible to attach two curved bends 22a and 23a that match the respective shapes of the second curved portion 23. Further, the angle and shape when the insertion portion main body 3a of the endoscope treatment tool 1 protrudes from the endoscope 2 can be adjusted by the two differently curved bending rods 22a and 23a. And a case where the approach of the insertion portion main body 3a of the endoscope treatment tool 1 is difficult, for example, a case where the upper part of the nipple is hanging down or a case where the endoscope 2 cannot be brought close to the nipple H3 such as a case of a parapapillary diverticulum For many cases, the insertion performance of the insertion portion main body 3a of the endoscope treatment tool 1 into the nipple H3 and the bile duct H1 can be improved.

Furthermore, the present invention is not limited to the above-described embodiment, and various modifications can be made without departing from the scope of the present invention.
Next, other characteristic technical matters of the present application are appended as follows.
Record
(Additional Item 1) In an endoscope treatment tool having a knife wire for incision of an affected part by high frequency, a knife wire exposed part is formed by an insulating member for which a part of the exposed part from the tube of the knife wire is intended for insulation. An endoscopic treatment tool that is insulated except for a range of 5 to 15 mm from the tip.

  (Additional Item 2) The treatment instrument for an endoscope according to Additional Item 1, wherein the insulating member is made of a material having high insulating performance, such as coating or tubing.

  (Additional Item 3) The endoscope treatment tool according to Additional Item 1, wherein the insulating member is made of a fluororesin such as PTFE, PFA, FEP, polyimide, or other resin.

  (Additional Item 4) The treatment instrument for an endoscope according to Additional Item 1, wherein the color of the insulating member is a color that can be easily distinguished from the knife wire.

  (Additional Item 5) The endoscope treatment tool according to Additional Item 1, wherein the color of the insulating member is a color that can be easily distinguished from the biological color in the body cavity.

  (Additional Item 6) The treatment instrument for an endoscope according to Additional Items 4 and 5, wherein the color of the insulating member is blue, white, green, or the like.

  (Additional Item 7) The endoscope treatment tool according to Additional Item 1, wherein a heat-shrinkable tube structure is used for the insulating member.

  (Additional Item 8) The endoscope treatment tool according to Additional Item 1, wherein the outer diameter of the insulating portion is the same as or close to the outer diameter of the knife wire.

  (Additional Item 9) In an endoscopic treatment instrument having a tube used by being inserted into the bile duct transpapillary, particularly in the pancreaticobiliary field, two R curves (first R / radius: 20 ± 5 mm, angle : Endoscopic treatment providing a bend to the tube with a pre-curve stylet (core metal) having: 210 ± 20 °, second R / radius: 60 ± 10 mm, angle: 120 ± 20 ° Ingredients.

  (Additional Item 10) The endoscopic treatment tool according to Additional Item 9, wherein a metal such as stainless steel or steel is used as a material for the pre-curve stylet.

  (Additional Item 11) The endoscope treatment tool according to Additional Item 9, wherein a shape memory alloy such as nitinol is used for the pre-curve stylet.

  (Additional Item 12) The endoscope treatment tool according to Additional Item 9, wherein a hard or soft plastic is used for the pre-curve stylet.

  (Additional Item 13) The endoscope treatment tool according to Additional Item 9, wherein a difference (gap) between the outer diameter of the pre-curve stylet and the inner diameter of the pre-curve stylet insertion lumen of the tube is 0.3 mm or less.

  (Prior Art of Additional Items 1 to 13) Japanese Patent Application Laid-Open No. H10-133787 is a conventional technology for additional items 1 to 13, and Japanese Patent Application Laid-Open No. H10-228260 is a conventional technology for additional items 1 to 8.

  (Problems to be solved by the supplementary items 1 to 13) The problem of Patent Document 1 is that when the scope body or tissue around the nipple is in contact with the knife wire, while viewing the image of the endoscope to prevent this, The operation of moving the outer sheath is necessary. When this operation is performed, the distal end of the tube is inserted into the bile duct transpapillary, but moving the outer sheath in this state increases the possibility that the tube will come out of the bile duct and nipple. . Further, in the shape of the vicinity of the nipple, for example, in a diverticulum case, the nipple is in a position deeper than the surrounding tissue, and the scope body may not be close to the nipple. In such a case, a long knife length may be advantageous in order to match the travel of the bile duct and the orientation of the tube and knife, but in the above invention, the tissue around the nipple that is not the target part on the hand side of the knife wire is used. There is a high possibility of damage. Further, in this state, since the knife wire is in contact with many tissues, the current density at the target site is low, and nipple incision becomes difficult.

  In the above invention, means for operating the direction and shape of the tube tip using an operation wire is introduced. In addition to the operation of the outer sheath and the knife wire, the operation wire for changing the direction is simultaneously operated. It is very difficult to do.

  The problem of Patent Document 2 is that it is possible to prevent adhesion of the knife wire to the contact tissue, but it is impossible to prevent contact other than the target site.

  (Object of Additional Items 1 to 8) The purpose of Additional Items 1 to 8 is to improve the safety and operability of the EST.

  (Purpose of Supplementary Items 9 to 13) The purpose of Supplementary Items 9 to 13 is to improve sheath insertion into a transpapillary bile duct by inexpensive and easy means.

  (Actions of Supplementary Items 1 to 8) Since the actions according to Supplementary Items 1 to 8 can have a knife function (can be incised) only at the tip 5 to 15 mm of the knife wire exposed portion, in EST, the nipple Only the thickness of the part can be incised, and damage to other tissues around the nipple and the scope can be prevented to the limit. In addition, since the knife function portion is short and the portion in contact with the tissue is small, the current density is high, and the incision can be reliably performed.

  (Actions of Supplementary Items 9 to 13) The actions of Supplementary Items 9 to 13 can easily add a pre-curve stylet-like shape to the tube. By adjusting the length of the tube, the direction and shape of the tube tip can be easily adjusted according to the opening of the nipple and the bile duct, and the tube can be easily inserted into the bile duct. .

  (Effects of Supplementary Items 1 to 13) According to the present invention, it is possible to perform EST safely and reliably even for conventional EST difficult cases, and to improve transpapillary bile duct insertion performance of the tube. is there.

1A and 1B show a first embodiment of the present invention, in which FIG. 1A is a side view showing a distal end portion of an insertion portion of an endoscope treatment tool, and FIG. Side view. The cross-sectional view of the tube of the insertion part in the treatment tool for endoscopes of 1st Embodiment. The longitudinal cross-sectional view of the principal part which shows the front-end | tip part of the tube of the insertion part in the treatment tool for endoscopes of 1st Embodiment. Explanatory drawing for demonstrating the connection part of the tube of the insertion part and operation part in the treatment tool for endoscopes of 1st Embodiment. Explanatory drawing for demonstrating the state which is performing EST using the treatment tool for endoscopes of 1st Embodiment. The side view which shows the external appearance of the front-end | tip part of the insertion part in the treatment tool for endoscopes of the 2nd Embodiment of this invention. The side view which shows the pre curve stylet in the treatment tool for endoscopes of 2nd Embodiment. The state which is performing EST using the treatment tool for endoscopes of 2nd Embodiment is shown, (A) is the treatment tool for endoscopes to the nipple in the case of a general nipple shape Explanatory drawing which shows the approach method of this, (B) is explanatory drawing which shows the approach method of the treatment tool for endoscopes to the nipple in the case where the upper part of the nipple is hanging down, (C) is the scope of the diverticulum case etc. Explanatory drawing which shows the approach method of the treatment tool for endoscopes to the papilla in the case which cannot be approached.

Explanation of symbols

    DESCRIPTION OF SYMBOLS 2 ... Endoscope, 3 ... Insertion part, 6 ... Knife wire (operation wire), 7a, 7b ... Slit (opening part), 9 ... Incision part (knife part), 10 ... Insulation part, 11 ... Coating (insulation coating) ).

Claims (2)

In a high-frequency incision tool that performs high-frequency incision of the duodenal papilla sphincter,
A tube-like flexible insertion part that is inserted into the body through an endoscope;
An opening that is disposed at a distal end of the insertion portion and communicates with the insertion portion;
An operation wire disposed in the insertion portion so as to freely advance and retract;
A wire-like conductive knife portion provided at the distal end of the operation wire and extending from the opening to the outside of the insertion portion;
Insulation made of fluororesin that covers a part of the outer surface located on the proximal side of the knife part exposed to the outside of the insertion part and is colored in a different color from the incision part made of the part exposed to the outside of the knife part Coating,
A high-frequency incision tool comprising: The high-frequency incision tool according to claim 1, wherein the insulating coating is formed by coating a fluororesin colored in a color different from the color of the knife part itself on a part of the outer surface of the knife part.

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