JPH057597A - High frequency exciser - Google Patents

Abstract

PURPOSE:To provide a safe high frequency exciser by eliminating possible cracking on a partition between a wire insertion path and a path for processing when an electroconductive wire is fixed on the wire insertion path with a lock member. CONSTITUTION:An electroconductive wire 10is inserted into a wire insertion path of a flexible electrically insulating sheath having a wire inserting path 6 and a path 8 for treatment and a part half way at the tip of the wire 10 is exposed to an external wall surface of the tip of the sheath 2 while the tip of the wire 10 is fixed on a fixing member 18 provided being fitted into the wire inserting path 6. Then, the wire 10 is pulled to bend the tip of the sheath 2 while the wire part exposed is extended to form an excising part 20. In a high frequency exciser 1 thus arranged, the fixing member 18 is mounted with a gap 26 for avoiding stress provided between the member and a partition 2a between the wire insertion path 6 and the path 8 for treatment.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a high-frequency incision instrument which is inserted endoscopically into a body cavity and incises a living tissue or the like.

[0002]

2. Description of the Related Art As a high-frequency incision tool, for example, Japanese Utility Model Publication No. 61-156911 and Japanese Utility Model Publication No. 63-16380.
The one shown in Japanese Patent Publication No. 3 is known. This is
As shown in FIG. 7, a conductive wire is provided in the wire insertion passage 82 of the electrically insulating flexible sheath 86 having two passages, that is, a wire insertion passage 82 and a treatment passage 84 through which a contrast medium is fed or a guide wire is passed. The wire 88 is inserted through the wire 88 so that only the middle portion of the tip of the wire 88 is exposed on the outer wall surface of the tip of the sheath 86, and the tip of the wire 88 is fixed in the wire insertion passage 82 by a stopper 90. And
The distal end portion of the sheath 86 is curved by pulling the wire 88, and the exposed wire portion is stretched to form an incision portion. The incision portion is brought into contact with the affected area and a high frequency is applied to the conductive wire. An electric current is passed to incise the affected part of the living body.

[0003]

By the way, in the conventional high-frequency incision device 80, a stopper member 90 for fixing the conductive wire 88 in the wire insertion passage 82.
Has a cylindrical shape and is fitted into the wire insertion passage 82. And this stop member 90 is generally
Has an outer diameter larger than the inner diameter of the wire insertion passage 82,
By elastically deforming and pressing the inner wall of the wire insertion path 82 in a radial direction, the wire insertion path 82 is pressed against the inner wall of the wire insertion path 82 and is securely fixed in the wire insertion path 82.

In such a fixing method, the wire insertion passage 8
The load is applied to the entire circumference of the inner wall of No.2. Further, as shown in FIG. 5, the partition wall 86a between the wire insertion passage 82 and the treatment passage 84 has a wall thickness that is particularly thinner than the other portions. Partition wall 86
A crack 92 is likely to occur in the portion a. When the crack 92 enters, the two passages 82 and 84 are communicated with each other, and when a treatment tool or the like, for example, a guide member is inserted into the treatment passage 84, a high-frequency current flowing through the wire 88 flows through the guide member to perform work. There is a possibility that the person or the patient may be seriously damaged.

Even when the outer diameter of the stopper member 90 does not exceed the inner diameter of the wire insertion passage 82, the stopper member 90 separates the wire insertion passage 82 and the treatment passage 84 from each other when the sheath 86 bends. The partition wall 86a to crack 9
2 may occur.

The present invention has been made in view of the above circumstances, and an object thereof is to provide a partition wall between a wire insertion passage and a treatment passage when a conductive wire is fixed to the wire insertion passage by a stopper member. (EN) Provided is a safe high-frequency incision tool which does not cause a crack in the inside.

[0007]

In order to solve the above problems, the present invention provides a conductive wire in an electrically insulating flexible sheath having a wire insertion passage and a treatment passage. The wire is inserted, the middle part of the tip of the wire is exposed on the outer wall surface of the tip of the sheath, and the tip of the wire is fixed to a fixing member fitted in the wire insertion passage. In the high-frequency incision device in which the distal end portion of the sheath is curved by pulling and the exposed wire portion is stretched to form an incision portion, the fixing member is provided between the wire insertion passage and the treatment passage. It is mounted with a gap for avoiding stress between the partition wall and the partition wall.

[0008]

Since a clearance for avoiding stress is provided between the fixing member and the partition wall between the wire insertion passage and the treatment passage, the fixing member separates the partition wall between the wire insertion passage and the treatment passage. No radial force is applied, thus
The partition walls are not cracked.

[0009]

Embodiments of the present invention will be described below with reference to the drawings. 1 and 2 show a first embodiment of the present invention. As shown in FIG. 2, the high-frequency incision tool 1 of the present embodiment is provided with a sheath 2 made of a flexible tube having an electrically insulating property that can be inserted into a channel of an endoscope and a proximal end portion of the sheath 2. The operation unit 4 is provided. As shown in FIG. 1A, a wire insertion passage 6 and a treatment passage 8 are provided in the sheath 2, and a conductive wire 10 is inserted in the wire insertion passage 6. The distal end of the sheath 2 is formed in a tapered shape in order to improve the insertability, whereby the wire insertion passage 6 is closed. Further, the treatment passage 8 is open at the distal end, and the guide wire and the contrast medium can be led out from the distal end of the sheath 2.

The base end portion of the wire 10 is electrically connected to the operation portion 4 connected to a high frequency power source (not shown).
The operation section 4 is provided with a wire operation handle 12 which is slidable along its axial direction, and the proximal end of the wire 10 is detachably fixed to the wire operation handle 12 via an operation pipe 14. There is.

The intermediate portion of the distal end of the wire 10 is one of the proximal end side of the pair of through holes 16a, 16b formed at the distal end of the sheath 2 at a predetermined interval along the axial direction. It is led out to the outside from 16b and introduced again to the inside from the other 16a, and its tip end is fixed to a fixing member 18 fitted in the wire insertion passage 6. And the wire 10
Of these, a portion exposed to the outside of the sheath 2 along the axial direction forms the incision 20. That is, the high frequency incision tool 1
Is to retract the wire operation handle 12 and pull the wire 10 to bend the distal end portion of the sheath 2 and stretch the exposed wire portion to form the incision 20.

On the proximal side of the sheath 2, the wire insertion passage 6 and the treatment passage 8 are branched at a constant angle to form a branch portion 22. A base 24 of the treatment passage 8 bent at a constant angle in the branch portion 22 is fixed with a base 24 that can be connected to a syringe or the like (not shown).
The syringe can be connected to inject a contrast agent into the treatment passage 8, or a treatment tool (not shown) such as a guide wire can be inserted.

By the way, the fixing member 18 has a substantially columnar shape, and as shown in FIG. 1C, a flat portion 18a formed by axially notching a side edge of the column is provided with a wire insertion path 6. A constant gap 2 for avoiding stress between the partition wall 2a and the treatment passage 8 in the direction of the partition wall 2a.
6 is formed. The outer diameter of the fixing member 18 is formed to be slightly larger than the inner diameter of the wire insertion passage 6, and the inner wall of the wire insertion passage 6 is elastically deformed and pressed in the radial direction so that the inner wall of the wire insertion passage 6 is The wires are pressed and securely fixed in the wire insertion passage 6. However, the fixed member 18 does not press the partition wall 2a portion because the fixed gap 26 is provided between the fixing member 18 and the partition member 2a. Further, in the present embodiment, the surface of the fixing member 18 facing the partition wall 2a between the wire insertion passage 6 and the treatment passage 8 is a flat surface, but it is used to avoid stress between the partition member 2a and the partition member 2a. Constant gap 26
A curved surface may be used as long as it is formed. In some cases, the fixability is better.

Next, the operation of the high-frequency incision instrument 1 having the above-mentioned structure will be described for the case of incising the duodenal papilla. First,
A contrast tube is inserted through a forceps channel of an endoscope that is previously introduced into the body cavity into the pancreatic duct that opens into the duodenum at the duodenal papilla, and a contrast agent is injected into the pancreatic duct through the contrast tube. By injecting this contrast agent, the position of the pancreatic duct can be confirmed by X-ray. Then, after the injection of the contrast agent, the guide wire is inserted into the pancreatic duct through the contrast tube of the contrast tube, and the contrast tube is removed with the guide wire left in the pancreatic duct. At this time, the contrast tube is removed while always holding the guide wire so that the guide wire does not come out of the pancreatic duct. For this reason, the guide wire used for this incision treatment should have a length twice or more that of the contrast tube.

Next, the high-frequency incision tool 1 is used with the guide wire still inserted in the pancreatic duct as a guide.
Is inserted into the pancreatic duct. That is, the guide wire is inserted from the proximal end portion thereof through the distal end of the treatment passage 8 of the sheath 2,
The sheath 2 is inserted into the forceps channel of the endoscope while holding the guide wire so as not to come out of the pancreatic duct, the tip of the sheath 2 is introduced into the pancreatic duct, and after the introduction, the guide wire is removed. Then, by retracting the wire operation handle 12 of the operation unit 4 to which the proximal end portion of the wire 10 is connected and pulling the wire 10, the distal end portion of the sheath 2 is curved toward the target teat and the incision portion. Two
0 is brought into contact with the teat, and in this state, a high frequency is applied to the wire 10 from a high frequency power source (not shown) to cut the teat. In the above operation, the contrast agent was injected into the pancreatic duct by the contrast tube, but it can also be injected through the treatment passage 8 of the high frequency incision tool 1.

In the high-frequency incision device 1 having the above structure, the fixing member 18 for fixing the conductive wire 10 to the wire insertion path 6.
Has a flat surface portion 18a. The flat surface portion 18a is directed toward the partition wall 2a between the wire insertion passage 6 and the treatment passage 8 and a constant gap 26 for avoiding stress is formed between the flat wall portion 18a and the partition wall 2a. Since it is formed, no radial force is applied to the partition wall 2a between the wire insertion passage 6 and the treatment passage 8, and the partition wall 2a
There is no crack in a.

Therefore, the wire insertion passage 6 and the treatment passage 8 are connected to each other, and when a treatment tool or the like, for example, a guide member is inserted into the treatment passage 8, a high frequency current flowing through the wire 10 flows to the guide member or the like. It does not cause a great deal of damage to workers or patients.

FIG. 3 shows a second embodiment of the present invention. The high frequency incision tool 30 of the present embodiment is the conductive wire 1
A fixing member 32 for fixing 0 to the wire insertion path 6 is formed in a plate shape as shown in FIG. Fixed member 3
The radial width of 2 is formed to be slightly larger than the inner diameter of the wire insertion passage 6, and as shown in FIG. 3B, the wire insertion passage 6 is slightly compressed against the inner wall of the wire insertion passage 6. Is fitted in the approximate center of the tip of the. Then, the fixing member 32
The one flat portion 32a is connected to the wire insertion passage 6 and the treatment passage 8.
A constant gap 34 for avoiding stress is formed between the partition wall 2a and the partition wall 2a in the direction of the partition wall 2a. The other structure is the same as that of the first embodiment.

Therefore, the high frequency incision tool 30 of this construction
Similarly to the first embodiment, the wire insertion passage 6 and the treatment passage 8 are also provided.
No radial force is applied to the partition wall 2a between
The partition wall 2a is not cracked.

FIG. 4 shows a third embodiment of the present invention. The high frequency incision tool 40 of the present embodiment is the conductive wire 1
A fixing member 42 for fixing 0 to the wire insertion path 6 is formed in a plate shape as shown in FIG. 4A, and its side portion is a tapered portion 42b formed in a tapered shape. Then, the taper portion 42b is fixed to the fixing member 42.
Is formed so that its width becomes gradually smaller toward the tip.

As shown in FIG. 4 (b), the fixing member 42 has a distal end portion of the wire insertion passageway 6 in a state where the base end portion having the largest width is slightly pressed against the inner wall of the wire insertion passageway 6. It is fitted in the center. Then, the fixing member 42 has one flat portion 42a directed toward the partition wall 2a between the wire insertion passage 6 and the treatment passage 8 and forms a constant gap 44 for avoiding stress between the partition member 2a and the partition wall 2a. ing. Other configurations are first
It is similar to the embodiment of. Therefore, similarly to the first embodiment, the high-frequency incision device 40 having this configuration does not apply a radial force to the partition wall 2a between the wire insertion passage 6 and the treatment passage 8, and the partition wall 2a does not. A crack does not occur, and the fixing member 42 is reliably fixed in the wire insertion path 6 by its widest base end portion.

Contrary to FIG. 4A, the taper portion 50b is formed such that the width of the fixing member 50 gradually increases toward the tip as shown in FIG. 4C. It may be. This improves the assemblability when fixing the fixing member 50 in the wire insertion path 6.

[0023]

As described above, according to the present invention,
Since a gap for avoiding stress is provided between the fixing member and the partition wall between the wire insertion passage and the treatment passage, the fixing member allows the diameter of the partition wall between the wire insertion passage and the treatment passage to be increased. No directional force is applied and therefore the partition wall is not cracked. As a result, the wire insertion passage and the treatment passage are connected to each other, and the high frequency current flowing through the wire does not cause a great deal of damage to the operator or the patient.

[Brief description of drawings]

FIG. 1 (a) is a side sectional view of the vicinity of the tip of a high-frequency incision tool showing the first embodiment of the present invention, and FIG. 1 (b) is AA of (a).
Sectional drawing which follows the line, (c) is a perspective view of the fixing member provided in the high frequency incision tool of (a).

FIG. 2 is a schematic configuration diagram of the high frequency incision instrument of FIG.

FIG. 3 (a) is a side sectional view of the vicinity of the tip of the high-frequency incision tool showing the second embodiment of the present invention, and FIG.
Sectional drawing which follows the line, (c) is a perspective view of the fixing member provided in the high frequency incision tool of (a).

FIG. 4A is a perspective view of a fixing member provided in a high frequency incision instrument according to the third embodiment of the present invention, and FIG. 4B is a tip of the high frequency incision instrument according to the third embodiment of the present invention. 10 is a vertical cross-sectional view of the vicinity of the portion, and FIG. 13C is a perspective view showing a modified example of the fixing member of FIG.

FIG. 5 is a vertical cross-sectional view showing a conventional example of a tip fixing portion of a cutting wire in a high-frequency cutting device.

[Explanation of symbols]

 1, 30, 40 ... High-frequency incision tool 2 ... Sheath 2a ... Partition wall 6 ... Wire insertion passageway 8 ... Treatment passageway 10 ... Wires 18, 32, 42, 50 ... Fixing member 20 ... Incision portion 26, 34, 44 ... Gap

Claims (1)

Claim: What is claimed is: 1. An electrically conductive wire is inserted into the wire insertion passage of an electrically insulating flexible sheath having a wire insertion passage and a treatment passage, and a tip midway portion of the wire is inserted. The sheath is exposed at the outer wall surface of the distal end portion of the sheath, and the distal end of the wire is fixed to a fixing member that is fitted in the wire insertion passage, and the distal end portion of the sheath is pulled by pulling the wire. In the high-frequency incision device that is curved and forms an incision by stretching the exposed wire portion, the fixing member is for avoiding stress between the wire insertion passage and the partition wall between the treatment passage. A high-frequency incision tool characterized by being installed with a gap.