JP4476229B2 - Bipolar saddle-shaped high-frequency treatment instrument for endoscope - Google Patents

Description

  The present invention relates to an endoscopic bipolar saddle-shaped high-frequency treatment instrument that is used by passing a high-frequency current through an endoscope treatment instrument insertion channel.

In general, a bipolar saddle type high-frequency treatment instrument for an endoscope is moved forward by remote control from the proximal end side of the flexible sheath at the distal end of the flexible sheath inserted into and removed from the treatment instrument insertion channel of the endoscope. A pair of high-frequency electrodes that open and close in a bowl shape are arranged so as to be electrically insulated from each other (for example, Patent Document 1).
JP 2003-299667 A

  When performing a mucosal incision or the like using the bipolar saddle-shaped high-frequency treatment instrument for endoscope, as shown in FIG. 11, the incision target mucosa 100 is sandwiched between a pair of high-frequency electrodes 91 and the high-frequency electrode 91 is inserted. By applying a high frequency current to the incision target mucosa 100 sandwiched between the pair of high frequency electrodes 91 is cauterized by Joule heat and cut.

  However, during such a high-frequency treatment operation, cauterization is performed very well even at the most distal portion 91a of the pair of high-frequency electrodes 91. Therefore, if a little forward force acts on the high-frequency electrode 91, the arrow A As shown in FIG. 8, there is a possibility that the high frequency electrode 91 cauterizes the normal mucous membrane 101 and proceeds in that direction to perforate the normal mucous membrane 101. Further, as shown in FIG. 12, there is a possibility that the back side portion 91 b near the tip of the high-frequency electrode 91 may touch the surrounding normal mucous membrane 101 and cauterize the normal mucous membrane 101.

  Accordingly, an object of the present invention is to provide a safe bipolar type saddle type high-frequency treatment instrument for an endoscope that does not cause ablation of normal surrounding mucous membranes other than the mucous membrane to be incised when performing incision or the like of the mucous membrane. .

  In order to achieve the above object, the bipolar saddle type high frequency treatment instrument for endoscope of the present invention has a flexible sheath attached to the distal end of the flexible sheath inserted into and removed from the treatment instrument insertion channel of the endoscope. A pair of high-frequency electrodes in a bipolar saddle-shaped high-frequency treatment instrument for an endoscope in which a pair of high-frequency electrodes that are opened and closed in a bowl shape toward the front by remote operation from the base end side are disposed with electrical insulation therebetween An electrically insulating insulating chip is attached to each leading edge of each of the electrodes so as to surround the leading edge of the high-frequency electrode, and at least the pair of high-frequency electrodes facing each other are exposed at a position behind the insulating chip. Is.

  The insulating chip protrudes from the surface of the high-frequency electrode outward from each of the tip surface side, the side surface side, and the back side of the surface where the pair of high-frequency electrodes face each other. It may be attached.

  In addition, the insulating chip may be provided only at the foremost portion of each high-frequency electrode. In that case, when the pair of high-frequency electrodes are closed, two insulating chips attached to each high-frequency electrode are combined. Each insulating chip may be formed in a substantially hemispherical shape so as to have a substantially spherical shape.

  Alternatively, the insulating chip may be attached so as to cover the entire high-frequency electrode so that only the opposing surfaces of the pair of high-frequency electrodes are exposed, and each insulating chip is connected to the pair of high-frequency electrodes. You may form in the substantially fan-shaped cross-sectional shape which tapers toward the surface side which opposes.

  According to the present invention, an electrically insulating insulating chip is attached to the tip of each of the pair of high-frequency electrodes so as to surround the tip of the high-frequency electrode, and at least a pair of the high-frequency electrodes are opposed to each other and the opposite surfaces are insulated. By exposing at a position behind the chip, when performing mucosal incision or the like, high-frequency treatment can be performed very safely without fear of cauterizing surrounding normal mucous membranes other than the mucosa to be incised.

  A pair of high-frequency electrodes that open and close in a hook-like shape by remote control from the proximal end side of the flexible sheath are attached to the distal end of the flexible sheath inserted into and removed from the treatment instrument insertion channel of the endoscope. In an endoscopic bipolar saddle-shaped high-frequency treatment instrument arranged with electrical insulation between them, an electrically insulating insulating chip is placed in a state of surrounding the leading edge of the high-frequency electrode at the leading edge of each of the pair of high-frequency electrodes. Attach and expose at least a pair of high-frequency electrodes facing each other at a position behind the insulating chip.

Embodiments of the present invention will be described with reference to the drawings.
FIG. 5 shows the overall configuration of a bipolar saddle-shaped high-frequency treatment instrument for an endoscope according to a first reference example of the present invention. Electricity inserted into and removed from a treatment instrument insertion channel of an endoscope (not shown). A pair of high-frequency electrodes 2 that are electrically insulated from each other are disposed at the distal end of an insulating flexible sheath so as to be openable and closable in a hook shape toward the front. Two conductive operation wires 3 are inserted and arranged in parallel in the flexible sheath 1, and the tips of the operation wires 3 are individually connected to the high-frequency electrode 2.

  An operation portion 10 is connected to the proximal end of the flexible sheath 1, and the proximal end portions 3 a of the two operation wires 3 drawn out from the proximal end of the flexible sheath 1 in the operation portion 10 are arranged. The pair of power cords 12 are fixed to a slide operation member 11 slidably provided on the operation unit 10, and are further connected to the operation wire 3 to extend outward from the slide operation member 11 to the operation unit 10. A connection plug 13 is attached to the tip.

  As a result, by connecting the connection plug 13 to a high-frequency power supply device (not shown), the pair of high-frequency electrodes 2 are connected to the positive electrode and the negative electrode of the high-frequency power supply via the operation wire 3 and are slid. When the operation member 11 is slid, the high frequency electrode 2 is opened and closed in a hook shape via the operation wire 3.

  FIG. 1 is a side view of the vicinity of the distal end of the flexible sheath 1, and FIG. 2 is a side cross-sectional view. The flexible sheath 1 is an electrically insulative material having a good sliding property such as a tetrafluoroethylene resin sheath. It is formed by a flexible tube.

  A support frame 4 formed of an electrical insulating material for supporting the high-frequency electrode 2 is fixedly connected to the distal end of the flexible sheath 1 so as to protrude straight forward from the flexible sheath 1. A pair of high-frequency electrodes 2 are individually rotatably supported on a pair of support shafts 5 attached near the tips. Note that at least one of the pair of support shafts 5 is provided with an electrical insulation coating or the like, and the pair of high-frequency electrodes 2 are electrically insulated from each other.

  Reference numeral 2 a denotes a drive arm formed integrally with each high-frequency electrode 2 so as to extend rearward from the engaging portion with the support shaft 5, and a pair of operation wires 3 inserted into the flexible sheath 1. Is connected to the vicinity of the rear end of the drive arm 2a.

  As a result, when the operation wire 3 is operated to advance and retract in the axial direction from the base end side, each drive arm 2a rotates about the support shaft 5 so that the pair of high-frequency electrodes 2 can rotate about the support shaft 5 as a rotation axis. Open and close. Note that at least one of the pair of operation wires 3 is provided with an electrical insulation coating 3c, and the pair of operation wires 3 is electrically insulated from each other.

  An insulating chip 20 having heat resistance and electrical insulation properties, such as a ceramic material, is provided at the most distal portion of the pair of high-frequency electrodes 2 thus configured so as to surround the most distal portion of each high-frequency electrode 2. It is fixed to one piece.

  Each insulating chip 20 is a front view of the bipolar saddle-shaped high-frequency treatment instrument for endoscope as viewed from the front, and FIG. 3 is a single perspective view of the high-frequency electrode 2 to which the insulating chip 20 is integrally attached. As shown in FIG. 4, when the pair of high-frequency electrodes 2 are in a closed state, the two insulating chips 20 attached to each high-frequency electrode 2 are formed in a substantially hemispherical shape so as to be substantially spherical. And it is attached only to the most advanced part of each high-frequency electrode 2.

  As shown in FIG. 1 and FIG. 2, the insulating chip 20 is outward from each of the front end surface side of the foremost portion of each high-frequency electrode 2 and the back side of the surface 2 c where the pair of high-frequency electrodes 2 face each other. And is protruded from the surface of the high-frequency electrode 2 outward from the side surface of the most distal end portion of each high-frequency electrode 2 as shown in FIGS. The surface 2c which is attached to the state and faces the pair of high-frequency electrodes 2 is exposed at a position on the rear side of the insulating chip 20.

As shown in FIG. 6, the bipolar type saddle-shaped high-frequency treatment instrument for an endoscope of the reference example configured as described above has a mucosa 100 to be incised between a pair of high-frequency electrodes 2 when incising the mucous membrane or the like. When a high-frequency current is applied to each high-frequency electrode 2 while sandwiching between them, the incision target mucosa 100 sandwiched between the pair of high-frequency electrodes 2 is cauterized and cut by Joule heat, and at that time, the cutting-edge mucosa 100 Since the insulating chip 20 is attached, there is no risk of perforating the normal mucous membrane 101 at the tip of the high-frequency electrode 2 or touching the normal mucous membrane 101 at the back of the high-frequency electrode 2 to cause cauterization. Treatment can be performed.

FIG. 7 is a single perspective view of the high-frequency electrode 2 to which the insulating chip 20 is integrally attached, according to the first embodiment of the present invention. It is formed in a substantially fan-shaped cross section that tapers toward the side. Other configurations are the same as those in the first reference example described above.

With this configuration, as shown in FIG. 8, the insulating chip 20 is unlikely to hinder the operation of sandwiching the incision target mucosa 100 between the pair of high-frequency electrodes 2. It can be easily performed, and the same effect as the first reference example described above can be obtained, so that high-frequency treatment can be performed very safely.

FIG. 9 is a single perspective view of the high-frequency electrode 2 to which the insulating chip 20 of the second reference example of the present invention is integrally attached. Each surface 20 of the insulating chip 20 is opposed to the pair of high-frequency electrodes 2 facing each other. In this state, the entire high-frequency electrode 2 is covered with only the exposed portion. Other configurations are the same as those in the first reference example described above.

Even if comprised in this way, the effect similar to the above-mentioned 1st reference example is acquired, and a high frequency treatment can be performed very safely, and also like 2nd Example shown by FIG. If the pair of high-frequency electrodes 2 are formed to have a substantially fan-shaped cross section that is tapered toward the surface 2c facing each other, the high-frequency treatment with the pair of high-frequency electrodes 2 can be performed more easily.

It is a side view near the front-end | tip of the bipolar type scissors high frequency treatment tool for endoscopes of the 1st reference example of this invention. It is side surface sectional drawing near the front-end | tip of the bipolar type scissors high frequency treatment tool for endoscopes of the 1st reference example of this invention. It is a front view of the front-end | tip part of the bipolar type scissors high frequency treatment tool for endoscopes of the 1st reference example of this invention. It is a single perspective view of the high frequency electrode to which the insulating tip of the bipolar saddle type high frequency treatment instrument for endoscope of the first reference example of the present invention is integrally attached. It is a side view which shows the whole structure of the bipolar cage type | mold high frequency treatment tool for endoscopes of the 1st reference example of this invention. It is a schematic diagram of the use condition of the bipolar type saddle type high frequency treatment instrument for endoscopes of the 1st reference example of the present invention. It is a single perspective view of the high frequency electrode to which the insulating tip of the bipolar saddle type high frequency treatment instrument for endoscope of the first embodiment of the present invention is integrally attached. It is a schematic sectional drawing of the use condition of the bipolar cage type | mold high frequency treatment tool for endoscopes of the 1st Example of this invention. It is a single-piece | unit perspective view of the high frequency electrode to which the insulation chip | tip of the bipolar type saddle type | mold high frequency treatment tool for endoscopes of the 2nd reference example of this invention was integrally attached. It is a single-piece | unit perspective view of the high frequency electrode to which the insulating chip | tip of the bipolar type saddle-shaped high frequency treatment tool for endoscopes of the 2nd Example of this invention was integrally attached. It is a schematic diagram of the use condition of the conventional bipolar type saddle type high frequency treatment instrument for endoscopes. It is a schematic diagram of the use condition of the conventional bipolar type saddle type high frequency treatment instrument for endoscopes.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Flexible sheath 2 High frequency electrode 2c The surface where a pair of high frequency electrodes face and oppose 3 Operation wire 5 Spindle 20 Insulating chip

Claims (3)

A pair of high-frequency electrodes that are opened and closed in a hook shape by remote control from the proximal end side of the flexible sheath are mutually attached to the distal end of the flexible sheath that is inserted into and removed from the treatment instrument insertion channel of the endoscope. In the bipolar type saddle-shaped high-frequency treatment instrument for endoscopes that is arranged with electrical insulation between,
With opposing surfaces of each other the pair of the high-frequency electrodes are disposed and exposed, respectively, the pair of high-frequency electrode of each of the at least a state surrounding the tip near portion of the electrically insulating insulation chip is mounted,
The insulating chip is formed in a substantially fan-shaped cross-sectional shape that gradually becomes narrower toward a surface side where the pair of high-frequency electrodes are opposed to each other. A bipolar saddle-shaped high-frequency treatment instrument for an endoscope, which is attached to each of the high-frequency electrodes so as to protrude outward from the surface of the high-frequency electrode on each of the back surfaces of the opposing surfaces . The insulating chip endoscopic bipolar beak-surgical device of claim 1 Symbol placement is provided only on the cutting edge portion of each high-frequency electrode.   2. The bipolar type saddle-shaped high frequency for an endoscope according to claim 1, wherein the insulating chip is attached so as to cover the whole of the high-frequency electrodes so that only the opposing surfaces of the pair of high-frequency electrodes are exposed. Treatment tool.

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