JPH07111974A - Treating device for inside of celom - Google Patents

Abstract

PURPOSE:To improve inserting property and operability by arranging a flexible pipe comprising a superelastic alloy at least at a part of a flexible tube. CONSTITUTION:A flexible tube part 4 of biopsy forceps 1 is made up of a superelastic alloy pipe, which ensures excellence in the transmittability of a torque to transmit rotation to the tip side from the hand side so that a biopsy cup 5 can be turned to an affected part to improve pinpointing performance. Moreover, the facilitating of plastic deformation can be prevented to eliminate undesired persistent bending to improve forced following property of an inserting part 2 of the biopsy forceps 1 from the hand side, which upgrades the performance of inserting an endoscope curved into a channel and an organic lumen bent. A less thickness of the flexible tube part 4 is possible to allow finer outer diameter of an inserting part 2 of the biopsy forceps 1. This also enables the increasing of a buckling strength of the flexible tube part 4 with respect to a compression force working on the flexible tube part 4 when an operation wire 10 is pulled to sample a tissue by closing the biopsy cup 5 to prevent the kinking of the flexible tube part 4, thereby enhancing forced following property.

Description

Detailed Description of the Invention

[0001]

2. Description of the Related Art Conventionally, in a biopsy forceps or the like which is a treatment tool for an endoscope, a jacket of an insertion portion to be inserted into a body cavity is composed of a flexible tube such as a coil sheath. A treatment operation means such as a biopsy cup is provided at the tip of the insertion portion. An operation wire for operating the treatment operation means is inserted into the coil sheath.

Further, a proximal side operation portion is provided at the proximal end portion of the insertion portion. An operating handle is provided on the proximal operating section, and the proximal end of the operating wire is connected to the operating handle. When operating the treatment work means, the operation force of the operation handle is transmitted from the hand side to the treatment work means via the operation wire, and the treatment work means is remotely operated.

[0003]

However, when the outer cover of the insertion portion is formed of a flexible tube such as a coil sheath as in the above-described conventional structure, the following will occur especially when the diameter of the insertion portion is reduced. There are drawbacks. That is, the torque transmissibility from the operation portion on the hand side to the treatment work means side is low, and it becomes difficult to rotate and direct the tip portion in a desired direction.

Further, when the diameter of the conventional coil sheath or tube sheath is reduced, when the operation wire is pulled and the biopsy cup is closed to collect the tissue, a compressive force acts on the flexible tube portion. . At this time, since the coil row of the coil sheath is likely to be disturbed, buckling, and the tube are broken, the pushing followability is low (the waist is weak), and the insertability into the bent thin tubular lumen is reduced. Therefore, there is a problem that it becomes difficult to perform push-insertion operation into the endoscope channel or the biopsy lumen. This becomes remarkable as the diameter of the insertion portion is reduced.

Further, meandering is likely to occur over the entire length of the sheath during insertion of the endoscope channel into the lumen of the biopsy, and the reliability of the opening / closing operation of the biopsy forceps cup may be reduced. The present invention has been made in view of the above circumstances, and an object thereof is to provide an intracorporeal treatment instrument capable of improving insertability and operability.

[0006]

According to the present invention, an insertion portion to be inserted into a body cavity is formed by a flexible tube, and a treatment working means is provided at the tip of the insertion portion, and the treatment working means is remotely operated. In a body cavity treatment instrument in which force transmitting means for transmitting an operating force to the treatment working means from the proximal side is provided in the flexible tube of the insertion portion, at least a part of the flexible tube is made of a superelastic alloy. The flexible pipe is formed.

[0007]

[Function] A flexible pipe made of a super elastic alloy enhances torque transmissibility for transmitting rotation from the hand side to the tip side,
The tip is rotated in a desired direction so that it can be easily pointed, and especially when the flexible tube has a reduced diameter, the followability of pushing from the proximal side is improved, and the insertability and operability are improved. Is.

[0008]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment of the present invention will now be described with reference to FIGS.
This will be described with reference to (E). FIG. 1 (A) shows the tip of the biopsy forceps 1 for an endoscope, 2 is the insertion part of the biopsy forceps 1, 3 is the proximal side of the insertion part 2 as shown in FIG. 1 (B). Is an operation handle connected to the base end of the. The operation handle 3 is provided with a fixed portion 3a and a movable portion 3b that moves along the axial direction in a direction in which the fixed portion 3a comes in contact with and separates from the fixed portion 3a.

A flexible tube portion 4 is provided in the insertion portion 2, and a biopsy cup (treatment operation means) 5 is arranged at the tip of the flexible tube portion 4. Here, the flexible tube portion 4 is made of a superelastic alloy. This superelastic alloy material is Ni-
A Ti-based alloy is suitable.

Further, the biopsy cup 5 is provided with a pair of cup members 6, 7 which can be opened and closed. Extending portions 6a and 7a extend toward the flexible tube portion 4 side from the base end portions of these cup members 6 and 7.

As shown in FIG. 1C, the cup members 6 and 7 are rotatably supported by a pivot pin 8 which is provided at the tip of the flexible tube portion 4. Further, the flexible tube portion 4
A substantially pantograph type link mechanism portion 9 is arranged at the tip end of the. The cup members 6 and 7 are connected to the distal end of the operation wire (force transmission means) 10 via the link mechanism 9. The operation wire 10 is arranged in the flexible tube portion 4 so as to be movable along the axial direction. The proximal end portion of the operation wire 10 is connected to the movable portion 3b of the operation handle 3. Further, the operation wire 10 is made of a super elastic alloy material like the flexible tube portion 4.

In addition, the tip of the flexible tube portion 4 is shown in FIG.
As shown in, a pair of left and right cutouts 11a and 11b are formed so as to correspond to the operation of the link mechanism 9. Further, the link mechanism unit 9 includes a pair of link members 12, 13
Is provided. Here, the tip of one link member 12 is the tip of the extending portion 6a of the one cup member 6, and the tip of the other link member 13 is the other cup member 7.
Are respectively rotatably connected to the distal ends of the extending portions 7a. Further, the base end portions of both link members 12 and 13 are rotatably connected to a connecting member 14 connected to the distal end portion of the operation wire 10.

Therefore, in the above structure, the flexible tube portion 4 of the biopsy forceps 1 is made of a superelastic alloy pipe.
The torque transmissibility that transmits the rotation from the hand side to the distal end side is excellent, the biopsy cup 5 can be oriented in a desired direction with respect to the affected area, and the sniper property is improved.

Further, the followability of pushing the insertion portion 2 of the biopsy forceps 1 from the proximal side is improved, and the insertability into the channel of the curved endoscope and the bent body lumen is improved. This is especially true when the diameter of the flexible tube portion 4 is reduced, for example, φ1.
When it is less than or equal to mm, a remarkable effect is exhibited.

Further, the buckling strength of the flexible tube portion 4 is increased against the compressive force acting on the flexible tube portion 4 when the operation wire 10 is pulled, the biopsy cup 5 is closed and the tissue is collected. Therefore, the bending of the flexible tube portion 4 can be prevented and the pushing followability can be improved.

Further, by using a superelastic alloy pipe as the flexible tube portion 4, it is easy to plastically deform against a large bending strain as in the case where the flexible tube portion 4 is made of, for example, a stainless pipe or the like, which is unnecessary. It is possible to prevent a sharp bend. Further, by using the metal pipe as the flexible tube portion 4, the flexible tube portion 4 can be thinned and the outer diameter of the insertion portion 2 of the biopsy forceps 1 can be reduced.

Further, since the operating wire 10 is made of a super elastic alloy, the pushing followability of the operating wire 10 is improved, the followability of the opening / closing operation of the biopsy cup 5 is improved, and the open / close operation with good response is achieved. it can. In addition, the operation wire 10 itself is less likely to bend and contributes to improvement in followability.

FIG. 2 shows a second embodiment of the present invention. This applies the present invention to the basket forceps 21 for crushing stones. In FIG. 2, reference numeral 22 is an insertion portion of the basket forceps 21. The insertion portion 22 is provided with a flexible tube portion 23, and a basket portion (treatment work means) 24 made of a wire is provided at a tip portion of the flexible tube portion 23. The basket portion 24 is connected to the distal end portion of the operation wire 26 via the connection portion 25. Here, the flexible tube portion 23 and the operation wire 26 are both the first
Similar to the above example, it is made of a super elastic alloy. A thin-walled portion 27 having a tapered shape is formed at the tip of the flexible tube portion 23.

Therefore, in the above-mentioned structure, in addition to the effect of the first embodiment, since the tapered thin portion 27 is provided at the distal end portion of the flexible tube portion 23, for example, the duodenal papilla or the like. The insertability into the narrow lumen entrance is further improved.

FIG. 3 shows a third embodiment of the present invention. This applies the present invention to the grasping forceps 31. In FIG. 3, reference numeral 32 is an insertion portion of the grasping forceps 31. The insertion portion 32 is provided with a flexible tube portion 33, and a grasping portion (treatment work means) 34 is provided at a tip end portion of the flexible tube portion 33. The grip 34 is connected to the connecting portion 3
It is connected to the distal end portion of the operation wire 36 via 5.
Here, both the flexible tube portion 33 and the operation wire 36 are made of a superelastic alloy, as in the first embodiment. A thin portion 37 is provided at the tip of the flexible tube portion 33 to reduce the diameter.

Therefore, even with the above structure, the same effect as that of the second embodiment can be obtained. Further, the grip portion 34 may be made of a super elastic alloy. In this case, when the polyp, the foreign matter, and the like are collected, even if the gripping portion 34 undergoes a large strain deformation, it is difficult for the grip portion 34 to be plastically deformed, and the collection can be reliably performed.

FIG. 4 shows a fourth embodiment of the present invention. This applies the present invention to the snare treatment tool 41. In FIG. 4, 42 is an insertion portion of the snare treatment tool 41. A tip tube 43 made of synthetic resin is provided at the tip of the insertion portion 42. A flexible tube portion is connected to the rear end portion of the tip tube 43. In this flexible tube portion, a jacket layer 45 made of a synthetic resin material is provided on the outer peripheral surface of the superelastic alloy pipe 44.

A loop wire (treatment work means) 46 is provided at the tip of the insertion portion 42. The loop wire 46 is connected to the distal end portion of the operation wire 48 via the connecting portion 47. The operation wire 48 is made of a super elastic alloy as in the first embodiment.

Therefore, the same effect as that of the first embodiment can be obtained with the above structure. In the above embodiment, a high-frequency current is passed through the loop wire 46 to cut it while squeezing a polyp or the like, so that an insulating jacket layer 45 is provided on the outer peripheral surface of the flexible tube portion.

FIG. 5 shows a fifth embodiment of the present invention. This is obtained by heat-treating the distal end portion of the flexible tube portion 4 of the curved biopsy forceps 51 of the first embodiment into a curved shape which is curved in a substantially arc shape in advance.
Further, 52 is a guide tube into which the biopsy forceps 51 is inserted.

Therefore, in the case of the above-mentioned structure, by pushing out the biopsy forceps 51 from the guide tube 52 or the endoscope channel, it is possible to aim at the affected area while bending. Here, the guide tube 52 corresponds to, for example, a trocar that is percutaneously inserted into the abdominal cavity.

Further, FIGS. 6A to 6C show the fifth embodiment of the present invention.
It shows a modified example of the embodiment. This is because a thinned portion 54 is provided at the tip of the flexible tube portion 4 of the fifth embodiment as shown in FIG. 6 (B).

Therefore, the same effect as that of the fifth embodiment can be obtained with the above-described structure, but in this case, the thinned portion 54 at the tip of the flexible tube portion 4 is used in particular. The distal end portion of the flexible tube portion 4 can be easily deformed.

FIG. 7 shows a sixth embodiment of the present invention. This is because the plurality of ultrafine pipes 61 made of a superelastic alloy are connected in a state of being arranged in parallel along a substantially circular shape so that the flexible tube portions 4, 23, 33 in each of the first to fifth embodiments are connected. Is configured.

Therefore, in the case of the above structure,
It is possible to obtain the same effects as those of the fifth embodiment, and particularly in this case, for example, water supply, air supply, suction, drug injection and the like can be performed on the affected area by using each pipe 61.

FIG. 8 shows a seventh embodiment of the present invention. This is a perforated tube 7 made of synthetic resin.
The flexible tube portion 73 is provided in each of the pair of inner holes 73, 73, and the biopsy forceps 1 of the first embodiment and the snare treatment tool 41 of the fourth embodiment are inserted therein. It is a thing. Here, the flexible tube portion 73 is made of a superelastic alloy.

Therefore, with the above-mentioned structure, the same effects as those of the other embodiments can be obtained. Furthermore, a so-called strip biopsy can be performed in which the affected area is pulled up by the biopsy forceps 1 and excised by the snare treatment tool 41.

FIG. 9 (A) shows the essential structure of the snare treatment instrument 81 for ablating the living tissue of the affected area by supplying high frequency power. Here, 82 is a snare treatment tool 81
Is the insertion part of. The insertion portion 82 is provided with a flexible tube portion 83. A loop-shaped snare wire (treatment work means) 84 is arranged at the tip of the flexible tube portion 83. The snare wire 84 is connected to the distal end portion of the operation wire 86 via the connecting portion 85.

The wire body 87 of the snare wire 84
As shown in FIG. 9 (B), a conductive polymer coating layer 89 is formed on the outer peripheral surface of the coating layer 89, and a hydrophilic lubrication treatment portion 88 subjected to hydrophilic lubrication treatment is formed on the surface of the coating layer 89. ing.

Therefore, in the above structure, a coating layer 89 of a conductive polymer is formed on the outer peripheral surface of the wire body 87 of the snare wire 84, and the surface of the coating layer 89 is provided with a hydrophilic lubrication treatment portion 88. Since the hydrophilic lubrication-treated portion 88 is formed, the adhesiveness with the living tissue is weaker than that of the wire body 87 of the snare wire 84 not subjected to the hydrophilic lubrication treatment. The biological tissue piece or the like attached to 87 can be easily peeled off. Therefore, the cleaning / disinfecting work of the snare wire 84 can be facilitated.

FIG. 10 shows the structure of the essential part of the detect probe 91. A coating layer 89 made of a conductive polymer is formed on the outer peripheral surface of the electrode for detection 92 disposed at the tip of the detection probe 91, and the surface of the coating layer 89 is made hydrophilic by a hydrophilic lubrication treatment. The lubrication processing portion 88 is formed. Therefore, also in this case, the same effect as that of the snare treatment instrument 81 of FIG. 9A can be obtained.

Further, FIG. 11 shows a papillotomy knife 101.
2 shows the configuration of the main part of FIG. A coating layer 89 of a conductive polymer is formed on the outer peripheral surface of the wire 102 disposed at the tip of the papillotomy knife 101, and the surface of the coating layer 89 is subjected to a hydrophilic lubrication treatment. Part 88
Are formed. Therefore, in this case as well, FIG.
The same effect as that of the snare treatment tool 81 can be obtained.

FIG. 12 (A) shows the main structure of the hot biopsy 111. This is shown in FIG.
As shown in (B), a coating layer 115 of a conductive polymer is formed on the outer peripheral surface of the cup body 113 of the pair of cups 112 disposed at the tips of the hot biopsy 111, and the surface of the coating layer 115 is hydrophilic. The hydrophilic lubrication processing portion 114 that has been subjected to lubrication processing is formed. Therefore, also in this case, the same effect as that of the snare treatment instrument 81 of FIG. 9A can be obtained.

Further, here, after the biopsy, the collected tissue is easily peeled off from the inner peripheral surface of the cup body 113. Furthermore, since the biological tissue pieces and the like attached to the cup body 113 can be easily peeled off, the cleaning / disinfecting work of the cup body 113 can be facilitated.

Further, FIG. 13A shows a main structure of the first laser probe 121. This is a metal hot tip 122 on the tip of the laser probe 121.
And a coating layer 124 of a conductive polymer is formed on the outer peripheral surface of the hot chip 122.
The surface of 24 is formed with a hydrophilic lubrication portion 123 that has been subjected to a hydrophilic lubrication treatment. Therefore, also in this case, the same effect as that of the snare treatment instrument 81 of FIG. 9A can be obtained.

Further, FIG. 13B shows a main structure of the second laser probe 131. This is because a sapphire tip 133 is connected to the tip of a laser probe 135 arranged in the sheath 132, a coating layer 136 of a conductive polymer is formed on the outer peripheral surface of the sapphire tip 133, and the coating layer 136 is formed. The surface is formed with a hydrophilic lubrication portion 134 whose surface is hydrophilically lubricated. Therefore, also in this case, the same effect as that of the snare treatment instrument 81 of FIG. 9A can be obtained.

FIG. 14A shows the heat probe 14
1 shows the configuration of the main part 1. In FIG. 14A, 1
42 is the sheath portion of the insertion portion, and 143 is the sheath portion 142.
The connector portion 144 connected to the base end portion of the sheath portion 142 is the distal end portion of the sheath portion 142. Here, as shown in FIG. 14B, the distal end portion 144 of the sheath portion 142 has a distal end portion main body 14
5, a coating layer 146 of a conductive polymer such as Teflon is formed on the outer peripheral surface of the coating layer 5, and the surface of the coating layer 146 is subjected to a hydrophilic lubrication treatment.
7 are formed. Therefore, in this case as well, FIG.
The same effect as that of the snare treatment tool 81 of (A) can be obtained.

Further, FIG. 14C shows that the conductive polymer sheet 151 which has been subjected to the hydrophilic lubrication treatment is profitable, and the surface of the conductive polymer sheet 151 is subjected to the hydrophilic lubrication treatment. Is formed. The conductive polymer sheet 151 is shown in FIGS. 9 (A) to 14 (A).
It is used by being wrapped around each treatment tool shown in. Therefore, the hydrophilic lubrication processing part 152 can be easily provided in each treatment tool shown in FIGS. 9 (A) to 14 (A). It should be noted that the present invention is not limited to the above-mentioned embodiments, and it is needless to say that various modifications can be made without departing from the gist of the present invention.

[0044]

According to the present invention, since a flexible pipe made of a superelastic alloy is arranged on at least a part of the flexible pipe,
The insertability and operability can be improved.

[Brief description of drawings]

FIG. 1 shows a first embodiment of the present invention (A)
Is a vertical cross-sectional view showing the distal end portion of the biopsy forceps for the endoscope, (B) is a side view showing the operation handle on the proximal side, (C) is a vertical cross-sectional view showing the support portion of the biopsy cup, (D). Is a plan view showing the distal end portion of the biopsy forceps for an endoscope, and (E) is a longitudinal sectional view showing a state in which the biopsy cup is opened.

FIG. 2 is a vertical sectional view showing a basket forceps according to a second embodiment of the present invention.

FIG. 3 is a vertical sectional view showing a grasping forceps according to a third embodiment of the present invention.

FIG. 4 is a vertical sectional view showing a snare treatment tool according to a fourth embodiment of the present invention.

FIG. 5 is a vertical sectional view showing a curved biopsy forceps according to a fifth embodiment of the present invention.

FIG. 6 is a vertical sectional view showing a modification of the fifth embodiment.

FIG. 7 shows a sixth embodiment of the present invention (A)
Is a cross-sectional view of the main part, and (B) is a vertical cross-sectional view of the main part.

FIG. 8 shows a seventh embodiment of the present invention (A)
Is a cross-sectional view of the main part, and (B) is a vertical cross-sectional view of the main part.

FIG. 9A is a vertical cross-sectional view showing the main configuration of the snare treatment tool, and FIG. 9B is a cross-sectional view of the snare wire.

FIG. 10 is a perspective view showing a main configuration of a detect probe.

FIG. 11 is a side view showing a main configuration of a papillotomy knife.

FIG. 12 (A) is a perspective view showing a main configuration of a hot biopsy, and FIG. 12 (B) is a vertical sectional view of the hot biopsy cup.

FIG. 13A is a vertical cross-sectional view showing a main part configuration of a first laser probe, and FIG. 13B is a vertical cross-sectional view showing a main part configuration of a second laser probe.

14A is a side view of a heat probe, FIG.
Is a vertical cross-sectional view of the tip portion of the heat probe, and (C) is a vertical cross-sectional view showing a conductive polymer sheet subjected to hydrophilic lubrication treatment.

[Explanation of symbols]

2, 22, 32, 42 ... Insertion part, 4, 23, 33 ... Flexible tube part, 5 ... Biopsy cup (procedure working means) 10, 26,
36, 48 ... Operation wire (force transmitting means), 24 ... Basket portion (treatment working means), 34 ... Gripping portion (treatment working means), 46 ... Loop wire (treatment working means).

Claims (1)

[Claims] 1. An insertion portion to be inserted into a body cavity is formed of a flexible tube, and a treatment working means is provided at a tip of the insertion portion, and an operating force for remotely operating the treatment working means is applied from a hand side. In the treatment tool for body cavity, wherein the force transmitting means for transmitting to the treatment working means is provided inside the flexible tube of the insertion portion, a flexible pipe made of a superelastic alloy is arranged on at least a part of the flexible tube. A treatment tool for body cavity, which is characterized by being installed.