JPH08140981A - Treatment jig for endoscope - Google Patents

Abstract

PURPOSE: To reduce the number of insertion holes, ports or trocars for introducing an endoscope treatment part into the celom by making it possible to disassemble and assemble a first treatment means unit and an insertion part unit and selecting the treatment means unit corresponding to a use state to combine the same. CONSTITUTION: An A-group for selecting the treatment means units of a treatment device 1 for an endoscope, a B-group preparing two or more kinds of insertion parts each becoming the jacket sheath of an insertion part to select the jacket sheath and a C-group preparing a large number of operation means parts becoming first and second operation means to select the units becoming the first and second operation means are provided. Desired unit parts are selected from the respective groups A, B, C to be combined to obtain the polyfunctional treatment device for an endoscope fitted to a use purpose. By this constitution, unit parts are selected corresponding to an operation state or the use easiness of an operator and combined to be used.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a treatment instrument for an endoscope used for treatment inside a body cavity while using the endoscope.

[0002]

2. Description of the Related Art Various treatment tools for endoscopes have been proposed so far. In general, a treatment tool for an endoscope has a treatment function unique to each treatment tool. For example, D
As disclosed in the specification of E7303021 and Japanese Utility Model Laid-Open No. 5-18512, there is proposed a device in which an insertion portion having a distal treatment portion and an operation portion are detachably attached to each other to provide compatibility.

However, this type of endoscope treatment tool has only one treatment means even if it is detached and replaced.
It is no different from simply using multiple endoscopic treatment tools, and in the end, it is necessary to prepare the treatment tools as a unit for the number of necessary treatment functions, and to use a large number of treatment tools. It wasn't so useful in reducing medical costs because it would have to be prepared.

Further, in endoscopic treatment, the number of treatment holes, ports, trocars, etc. for inserting the treatment instrument into the body cavity is limited, and in order to reduce the burden on the patient. It is desirable to reduce the number as much as possible. Therefore, even if you want to take various measures,
It was impossible to increase the number of treatment tools to be inserted into the body cavity at the same time.

Therefore, it is necessary to replace the endoscopic treatment tool each time a different treatment is performed, which makes the surgical operation inefficient. In addition, the time and effort required to replace the treatment instrument hinders efficient surgery, which is one of the causes of the burden on the patient such as an increase in the operation time. For these reasons, it is desirable that the endoscopic treatment tool be provided with a plurality of treatment functions, but in the prior art, the number of variations of the monoscopic endoscopic treatment tool is increased. No, in the end, the above problems were not solved.

On the other hand, recently, one treatment tool having a plurality of treatment functions is known (USP No. 5,2).
No. 01,759 and Japanese Utility Model Laid-Open No. 5-88507). However, in these cases, one treatment has a specific treatment function, and there is little room for free selection according to the situation of treating many functions. For this reason, there has not been an essential solution to the problem that various treatment means as described above cannot be used without increasing the number of treatment holes or trocars without changing the treatment tool. That is, even if one treatment tool is provided with a plurality of treatment functions, the combination thereof is determined from the beginning, and for example, as in US Pat. No. 5,201,759, two gripping means are used. When equipped with,
For example, when it is desired to exclude a disturbing organ while performing a peeling operation, an endoscopic treatment tool equipped with a peeling means and a discharging means must be prepared in advance.
After all, it is necessary to prepare as many types of endoscopic treatment tools as the number of combinations. For example, if there is only "α" as the type of treatment means, in the above-described single-function endoscope treatment tool, "α"
It would have been better if only the books were prepared, but in this case "α x α
It is necessary to align the treatment tools for endoscopes in the book, and in fact,
Since a plurality of operating means are added to this, more types will be prepared. Therefore, even if the replacement of the endoscopic treatment tool can be omitted, or even if there is an effect of reducing the number of treatment holes or ports or trocars, the equipment cost may increase and the medical cost may increase. There is a risk that this may cause an increase in the burden on the patient in another sense.

Therefore, in order to solve such a problem, a plurality of treatment means are selected and combined as in USP 5,224,931 and USP 5,312,391. , Some of them can be used systematically, but in US Pat. No. 5,224,931, for example, a treatment hole is provided in a treatment tool for an endoscope so that another treatment means can be used together. However, in this case, the only consideration is to insert the injection needle to perform cholangiography, and it is not possible to change the combination of the treatment means and the operation means, and the treatment hole provided in the insertion portion is not possible. Since there is only one type of direction, the systemability described above was poor.

Further, for example, USP No. 5,312,39
In the case of No. 1, in the case of considering a sleeve into which a plurality of endoscopic treatment tools are inserted, the respective endoscopic treatment tools also have sleeves, so that the outer diameter becomes remarkably large as a whole. Therefore, there is a problem that the burden on the patient is increased. For example, in the case of endoscopic surgery, the insertion diameter of the endoscopic treatment tool is generally about 5 mm in terms of the sleeve outer shape, and even if the outer diameter of the sleeve into which two of these can be inserted is simply calculated, the endoscopic treatment is performed. Diameter of channel hole for inserting tool φ
5 mm × 2 + partition wall thickness of the sleeve between channels (at least about 0.5 mm even if the sleeve is a metal) × 3, and the lock mechanism portion of the endoscopic treatment tool inserted therein as in the prior art described above. If it is provided, the thickness corresponding to that is also required. Therefore, it can be easily imagined that the outer diameter of the sleeve exceeds 12 mm, which is the limit value of the commonly used inner diameter of the trocar.

More specifically, referring to FIG. 25, this is one outer sheath 200 and two separate treatment tools 2.
This is an example in which 01 and 202 are incorporated, and each of the endoscopic treatment tools 201 and 202 includes an insulating sheath 204 through which the operating shaft body 203 thereof is inserted. Therefore, the outer sheath 200 has two insulating sheaths 204.
Two insertion holes 205 are formed for inserting each of them. Further, each insulating sheath 204 is locked to the outer tube sheath 200 by the lock mechanism portion 206.
Here, the outer diameter of the outer sheath 200 is such that the thicknesses of the two insulating sheaths 204 are accumulated, and the gap 207 between the insertion hole 205 of the outer sheath 200 and the insulating sheath 204 is also two. This amount is accumulated.

In general, since the outer diameter of the sheath 204 of such an endoscopic treatment tool is 5 mm, the outer diameter of the outer sheath 200 is at least "the diameter of the insertion hole 205 (usually .5. 5 mm) × 2 + thickness of outer sheath 200 (usually 0.5 mm or more even with a metal material) × 3 + thickness of lock mechanism portion 206> φ12.5 mm ”. Therefore, it is generally impossible to insert the trocar on the market (currently, the maximum insertion diameter φ12 mm), and it becomes necessary to prepare a dedicated trocar. Therefore, in order to use the trocar of this type, it is necessary to prepare an extra trocar, so even if the above problems are solved, the trocar that is generally used cannot be used. Moreover, since it is necessary to prepare a dedicated trocar, it is uneconomical to reduce the cost. Further, since the diameter of the trocar becomes thicker, there was a problem not only in the point of being minimally invasive, which is an advantage of endoscopic surgery.

[0011]

As described above, in the prior art, it is not possible to reduce the number of insertion holes or ports, trocars, etc. in order to introduce the endoscopic treatment tool into the body cavity. However, it is necessary to prepare a large number of endoscopic treatment tools, and therefore, it is not possible to suppress an increase in medical equipment cost. Further, it is still necessary to replace the endoscopic treatment tool for each different treatment, which causes inconvenience such as inefficient surgical operation.

The present invention has been made by paying attention to the above-mentioned problems of the prior art, and an object thereof is to insert an insertion hole or a port or a trocar for introducing a treatment instrument for an endoscope into a body cavity. Since it is possible to reduce the number of etc., and it is possible to use a plurality of treatment functions in a systematic combination, it is possible to use a combination of the ultimate treatment functions according to the intended treatment, Since it is not necessary to replace the treatment tools during the surgery, it is possible to efficiently perform the surgical work, and to reduce the increase in medical equipment costs due to the large number of treatment tools for endoscopes. An object is to provide a treatment tool for an endoscope.

[0013]

SUMMARY OF THE INVENTION The present invention relates to an endoscopic treatment tool used for treating a site inside a body cavity under an endoscope, and at least one first operating means unit.
At least one insertion unit unit that is connected to the first operation unit and is inserted into a body cavity, and a treatment on living tissue by operating the first operation unit unit that is located at a distal end of the insertion unit unit. At least one first treatment means for performing and at least one second treatment means unit incorporated in the insertion section unit are provided, and the first treatment means unit and the insertion section unit can be disassembled and assembled at least. It is intended. Since the first treatment means unit and the insertion portion unit can be disassembled and assembled at least, the treatment means unit is selected and combined according to the use situation, and the use situation is combined into one endoscope treatment tool. It is used with multiple functions suitable for each.

[0014]

【Example】

<First Embodiment> A first embodiment of the present invention will be described with reference to FIGS. The system of the treatment tool for an endoscope according to this embodiment selects a desired unit component from each group A, B, C of the treatment means, the insertion portion, and the operation means shown in FIG. 3 as necessary. By combining these, the multifunctional endoscopic treatment tool 1 to be used is configured, and its function varies depending on the selected component. FIG. 1 shows a treatment tool 1 for an endoscope of one mode thereof.

As shown in FIG. 1, the endoscopic treatment tool 1 includes:
Usually, an outer sheath 2 as an insertion portion, a first treatment means unit 3 as a first treatment means and a second treatment means unit 4 as a second treatment means which are respectively incorporated in the distal ends of the outer sheath 2, and a proximal end of the outer sheath 2. It is provided with a first operating means unit 5 as a first operating means and a second operating means unit 6 as a second operating means which are respectively assembled in the vicinity. The first treatment means unit 3 is operated by the first operation means unit 5, and the second treatment means unit 4 is
It is operated by the second operation means unit 6. this is,
Compared with a normal endoscopic treatment tool that does not include the second treatment means unit 4 and the second operation unit 6, in that it is multifunctional in that it includes the first treatment means unit 3 and the second treatment means unit 4. Therefore, it can be called a so-called multifunctional forceps (treatment tool).

FIG. 2 shows a state in which the endoscopic treatment tool 1 shown in FIG. 1 is disassembled into unit parts. First
The treatment means unit 3 and the second treatment means unit 4 are
Each of the operation shafts 11 has an exposed operation shaft 11, and the tip of each operation shaft 11 is connected to a forceps 13 attached to a tip member 12 via a drive mechanism (not shown). By moving the operating shaft 11 back and forth, the forceps 13 can be opened and closed via a drive mechanism (not shown). The tip member 12 has an engagement groove (snap fit) on its outer periphery for detachably engaging a protrusion (not shown) formed on the inner diameter of the distal end of the outer sheath 2.
15 is formed.

At the base end (proximal end) of the operating shaft 11, a ball-like connecting end is detachably connected to the corresponding operating portions of the first operating means unit 5 and the second operating means unit 6. 16 are provided. The operation means units 5 and 6 shown in FIGS. 1 and 2 are connected to each other to form one unit. That is, one fixed handle 1
7 and a first movable handle 18 pivotally attached to each of them
And a second movable handle 19 is provided. The fixed handle 17 has a hole (not shown) into which the proximal end portion of the outer sheath 2 is fitted, and the proximal end portion of the outer sheath 2 inserted into this hole is fastened with a fixing screw 21 to fix them. ing. Both can be separated by loosening the fixing screw 21.

Each movable handle 18, 19 is provided with a first movable handle 18 and a second movable handle 19 which are pivotally attached to the fixed handle 17, and the first movable handle 18 and the second movable handle 19 are movable with respect to the fixed handle 17. The handle 18 and the second movable handle 19 are biased toward the position indicated by the alternate long and short dash line by elastic members 22 such as springs. The first movable handle 18 serves as a first operating means, and the second movable handle 19 serves as a second operating means. It can be operated individually.

The endoscopic treatment tool 1 as described above is
Each part in the disassembled state as shown in FIG. 2 is assembled into the state as shown in FIG. That is, the mantle sheath 2
The respective operation shafts 11 of the first treatment means unit 3 and the second treatment means unit 4 are respectively inserted into the inner holes of the above, and the engagement groove (snap fit) 15 of the tip member 12 is fitted into the outer sheath 2.
It is assembled by engaging with a protrusion (not shown) formed on the inner diameter portion of the tip of the operating shaft 11 and directly connecting the connecting end 16 of the operating shaft 11 to the movable handles 18 and 19.

When the first movable handle 18 is operated in the assembled state as described above, the first treatment means unit 3
The forceps 13 can be opened / closed, and the second movable handle 19 can be operated to open / close the forceps 13 of the second treatment means unit 4. Such a treatment tool 1 for an endoscope is used for ligating a thread in a body cavity,
It can be used for dissection of a lesion.

The endoscopic treatment tool 1 thus assembled can be disassembled again in the reverse order. These connecting means may be of any type as long as they can be separated or assembled, and there is no limitation on the structure, form or the like.

The endoscopic treatment tool 1 is disassembled into a plurality of unit parts as described above. However, each unit part as shown in FIG. 3 is appropriately replaced to another unit having a plurality of different functions. It is possible to obtain the endoscopic treatment tool 1. That is, the endoscope treatment tool 1 includes the first treatment means and the second treatment means, respectively.
A large number of treatment means parts to be used for the treatment means are prepared, and from this, group A for selecting each treatment means unit and a plurality of kinds of insertion part parts to be the outer sheath 2 of the insertion part are prepared. A group B for selecting 2 and a large number of operation means parts to be the first operation means and the second operation means are prepared, and a unit to be the first operation means and the second operation means is selected from this. C group for doing.

As the treatment means unit in the group A, in addition to that shown in FIG. 1, various known gripping forceps 26, high-frequency electrodes 27, and the like are given as examples. be able to. Examples of the parts that become the outer sheath 2 in the group B include, as an example, those shown in FIG. Tubes 2d, 2
Various things such as e can be mentioned. Further, as the parts of the operation means unit as the group C, in addition to those shown in FIG. 1, examples thereof include those of the type shown in FIG. Each operating means unit 28a, 28b, 28c shown in FIG. 3 is provided with a movable lever 30 in addition to the movable lever 29 for operating the forceps. For example, the movable lever 29 is the first operating means, and the forceps is used. Is used for opening and closing, and the movable lever 30 is used as a second operating means and is an energizing switch for the electrodes, and the like, respectively, to constitute first operating means and second operating means of the operating unit. The first operating means and the second operating means of the operation unit do not have to be integrally assembled, and the first operating means and the second operating means are separated when they are removed from the insertion portion. It may be configured.

However, as the endoscopic treatment tool 1, a desired unit component is selected from each of the groups A, B, and C, and these components are combined to provide a multifunctional endoscope for a purpose of use. The treatment tool 1 for a mirror is obtained. The combination is
In addition to those described or illustrated herein, various conceivable ones are also included.

As described above, in the endoscopic treatment tool 1 according to the present embodiment, the endoscopic treatment tool 1 is disassembled into the treatment means, the insertion portion, and the operation means.
Since these can be assembled, the first treatment means unit 3, the second treatment means unit 4, the outer sheath 2 of the insertion unit, and the operation units of the operation means are used as in the system configuration example shown in FIG. It is possible to use them in any combination depending on the situation. For example, in the case of grasping and cutting a lesion part, a grasping forceps-shaped one is used as the first treatment means unit 3 and the second treatment means is used. It is possible to use scissors-shaped forceps for the unit 4 and high-frequency electrodes for the second treatment means. Therefore, they can be selected and used in combination depending on the surgical situation and the ease of use of the operator. Therefore, there is an effect that the function of the multi-function treatment instrument is further improved and is easy to use, and the efficiency of surgery is improved.

Further, when a part of the endoscopic treatment tool 1 is damaged by such a system, the unit of the damaged part is replaced to replace the entire endoscopic treatment tool 1. Since it is not necessary to do so and it is not necessary to re-arrange a plurality of multi-function treatment tools, it contributes to the cost reduction of the user and the medical cost reduction.

Therefore, a plurality of treatment functions can be systematically combined and used, the operation work is efficient and efficient, and the cost of medical equipment is increased by arranging a large number of endoscopic treatment tools. It is possible to construct an economical endoscopic treatment instrument system capable of suppressing an increase in

By the way, in general, a treatment tool for an endoscope has a more complicated structure and more fitting parts and gaps than ordinary surgical forceps. In order to prevent infection of persons, it is necessary to surely clean and sterilize the inside thereof, particularly the drive mechanism of each treatment means, the lumen of the insertion section unit, the inside of the operation means, and the like.
Furthermore, in the case of the endoscopic treatment tool 1 here,
There are a plurality of treatment means in order to have a plurality of functions, and as the number of treatment means and operation means increases, a multifunctional endoscope treatment tool usually has a portion requiring cleaning and sterilization inside. This is a considerable increase as compared with an endoscopic treatment tool having only a single treatment means. For this reason, it is likely that it will be quite difficult to reliably perform cleaning and sterilization.

However, as described above, according to the system of the endoscopic treatment tool 1, since the parts can be separated,
For example, the inside of the driving mechanism of the first treatment means unit 3 and the second treatment means unit 4, the lumen of the outer sheath 2 of the insertion portion, or the first operation means unit 5 or the second operation means unit 6 not shown. It becomes possible to effectively perform the cleaning and sterilization of the parts that were difficult to clean and sterilize in the past, such as the ditch.

Further, in the prior art shown in FIG. 25, individual endoscopic treatment tools are combined and incorporated into one outer sheath, but as described above, the outer diameter of the outer sheath increases, Commercially available trocar (generally insert diameter φ1
2mm) cannot be inserted, and it will be necessary to prepare a special trocar. Therefore, in order to use this conventional method, it is necessary to prepare an extra special trocar. Therefore, even if you solve the problem that you can not combine the above multiple treatment functions freely, you can not use a commonly used trocar, so you must prepare a dedicated trocar, It was uneconomical to cut costs. Further, since the diameter of the trocar becomes thicker, there was a problem not only in the point of being minimally invasive, which is an advantage of endoscopic surgery.

However, the endoscopic treatment tool 1 according to the present invention
Then, the operating shaft 11 does not have each outer sheath,
It can be directly inserted and incorporated into the outer sheath 2 of the treatment instrument insertion portion. Therefore, unlike the conventional one described above, the thickness of the treatment hole, the insulating sheath, the sheath, etc. is not accumulated, so that the outer diameter of the insertion portion can be suppressed to about 10 mm and it can be inserted into a commercially available trocar. , It is not necessary to prepare a special trocar,
Therefore, it is possible to reduce the extra spending and contribute to the reduction of the cost of medical equipment. Further, since a commercially available trocar can be used, the insertion diameter does not increase unnecessarily, and the advantage of minimally invasive endoscopic surgery is not impaired. In addition to this,
By providing a plurality of treatment means on one endoscope treatment tool 1, it is possible to reduce the number of guide holes for guiding the endoscope treatment tool 1 into a body cavity such as a trocar, and to reduce the invasiveness. It goes without saying that it will be useful.

Incidentally, the endoscopic treatment tool 1 of the above-mentioned embodiment.
In this case, two treatment means and two operation means are provided. For example, the endoscopic treatment tool 1 percutaneously inserted into the stomach as shown in FIG. 4 is used to excise gastric mucosa. In such a procedure called intragastric surgery, it is more effective to provide more treatment means because the number of holes opened in the abdomen and the stomach wall is reduced. For example, as shown in FIG. 4, gripping forceps 31, scissors forceps 32, and water supply / suction tube 33 may be provided as three types of treatment means.

Further, it may be an endoscopic treatment tool provided with four or more treatment means as required. As described above, the treatment means is not limited to two, and any number of treatment means may be used as long as the treatment means are combined in consideration.
In FIG. 4, 34 is a water supply / suction device communicating with the water supply / suction pipe 33, 35 is a high-frequency treatment power source, 36 is a trocar, and 37 is an endoscope.

Further, the endoscopic treatment tool 1 of the first embodiment is composed of four disassembleable and reassembleable units, but the number of the disassembled and reassembled units is not limited to four. Similar to the means, any structure that can be disassembled / assembled into, for example, three or five units may be used as long as the object of the present invention is met. <Second Embodiment> A second embodiment of the present invention will be described with reference to FIGS. This embodiment is the same as the first embodiment described above.
5 is another example of the combination of the systems shown in FIG. 3 in the embodiment of the present invention, and the endoscopic treatment tool 50 shown in FIG. 5 has an outer sheath 51 as an insertion unit, and a second treatment means along the outer sheath 51. A water supply / suction pipe 52 is attached. Further, the operation unit unit 53 of the first operating means is provided with the valve 54 of the second operating means.

The structure of the basic part of this is almost the same as that of the first embodiment described above, but a water supply / suction pipe 52 is attached to the lower portion of the outer sheath 51 as the second treatment means, and the water supply is performed. The proximal end of the suction pipe 52 is connected to the inside of the operation section unit 53 of the first operation means, and the valve 54 as the second operation means is provided on the side surface of the unit member 55 of the operation section unit 53. Is provided. A connection tube (not shown) can be connected to the valve 54 to supply water from a physiological saline pack (not shown) or to suck water or blood in the body cavity by an aspirator (not shown).

An energization pin 56 is provided on the upper part of the unit member 55 of the first operating means, and a first treatment means 57 having a gripping function by supplying a high frequency current from a high frequency power source (not shown) to this. A high-frequency current can be passed from the member to a tissue in the body cavity (not shown) in contact with the member to cauterize or coagulate the tissue in the body cavity.

Further, as shown in FIG. 6, an endoscopic treatment tool 50 is one in which the forceps unit portion 58 of the first treatment means 57, the outer sheath 51 and the first operation portion unit 59 are integrated, It can be disassembled into the valve 54 which is the second operation unit unit. Then, these can be assembled as shown in FIG.

Here, the forceps unit portion 61 of the first treatment means 57 is formed with a screw portion 62, which is used to connect to the distal end of the outer sheath 51. First treatment means 5
7, and the operation unit unit 53 of the first operation means, as in the first embodiment described above, a ball-shaped connecting portion 64 formed at the proximal end of the operation shaft 63, and an operation portion engaging with this. The unit 53 is detachably connected by an engaging groove (not shown) on the side of the unit 53. The valve 54 and the operation unit unit 53 of the first operation means are detachably connected by a cam lock 65. However, any connection means may be used.

The endoscopic treatment tool 50 having such a structure is as follows.
For example, the first treatment means 57 is established by determining the bleeding point by performing water supply / suction on the bleeding site of the tissue in the body cavity.
Thus, it is possible to stop the bleeding by the high frequency current while gripping the bleeding point. As a result, conventionally, two types of endoscopic treatment tools have been used to perform water supply / suction and hemostasis treatment. However, according to the present embodiment, one endoscopic treatment tool is used. Since the treatment can be performed, and further, for example, the treatment can be coagulated by a high frequency current while suctioning, there is an effect that the leakage of the high frequency current is small and the reliability of the treatment is improved.

In general, this type of endoscopic treatment instrument is about 10 times more expensive than ordinary surgical forceps, but it has a plurality of functions as in the present invention. Having a single endoscopic treatment tool also eliminates the need to prepare a plurality of expensive endoscopic treatment tools, which can contribute to a reduction in medical costs.

Therefore, with the above configuration, the above-mentioned first
Similar to the embodiment of the above, it is possible to surely clean and sterilize each part, and in particular, since the water supply / suction pipe or the valve 54 through which blood and the like in the body cavity circulate can be disassembled, the part where the dirt is most likely to become severe It can be surely washed and sterilized.

Further, since a system for exchanging parts of each part as shown in FIGS. 2 and 3 is constructed similarly to the first embodiment, various kinds of units can be used in combination. It becomes possible, and the treatment can be streamlined by using an optimal combination according to the purpose of use and the situation.
Further, similarly to the first embodiment, since the endoscopic treatment tool 50 can be disassembled and assembled into each unit, for example, when a part of the endoscopic treatment tool 50 is damaged, By exchanging the unit of the damaged portion, it is not necessary to exchange the entire endoscopic treatment tool 50, which has the effect of reducing the cost burden on the user, and helps reduce medical costs.

In the second embodiment, the number of valves 54 is two, but the number of valves 54 of that kind is not limited as long as it is within the range for the purpose of the present invention. Three
By individually using water supply / suction / air supply, it is possible to perform a treatment such as inserting the endoscopic treatment tool 50 into a place without a cavity while using the air supply and using the same.

In the endoscopic treatment tool 50 of this embodiment, as shown in FIG. 7, the jaw 6 of the first treatment means 57 is used.
6, a groove 67 is formed, and the water supply / suction pipe 52 of the second treatment means is formed.
And the first treatment means 57 are arranged coaxially with respect to the axial direction of the insertion portion, and water is supplied from the distal end of the jaw 66 of the first treatment means 57.
Suction may be performed. As described above, the modification of the entire structure of the endoscopic treatment tool is not particularly limited as long as it is within the scope of the object of the present invention. <Third Embodiment> A third embodiment of the present invention will be described with reference to FIGS. This embodiment is also the first described above.
4 is an example of a combination of the systems shown in FIG. 3 in the embodiment of FIG. Of course, the basic configuration is the same as that of the first embodiment, but the endoscopic treatment tool 70 includes a second treatment means unit (grasping device) as the second treatment means in the first embodiment. Instead of the forceps) 4, a hook 72 is provided as an insertion portion on the outer circumference of the outer sheath 71, and the hook 72 moves back and forth of a movable sheath 73 slidably fitted on the outer sheath 71. It is designed to open and close. That is, the portion of the movable sheath 73 constitutes the second operating means, and when the movable sheath 73 is advanced, the hook 7
2 is folded down to be closed, and finally stored in the movable sheath 73. When the movable sheath 73 is retracted, the hook 72 stands up and opens due to the elastic force of the hook 72 itself. This operation is performed by moving the knob 74 connected to the movable sheath 73 back and forth with respect to the outer sheath 71.

The endoscopic treatment tool 70 of this embodiment is also provided.
By rotating the knob 74 around the axis of the insertion section,
The entire insertion section unit 75 is rotatable with respect to the unit 76 of the first operation means section, and the function of the endoscopic treatment tool 70 is similar to that of the first embodiment. Used in ligating a thread within.

Further, as shown in FIG. 9, the treatment instrument 70 for an endoscope in this embodiment has an operation portion 77 as a first treatment means, a hook 72 as a second treatment means, and an outer sheath as an insertion portion. A unit part in which the sheath 71 is integrated,
Movable sheath 73 and knob 7 which are the second operation means unit
8 is divided into a unit part in which 4 is integrated and a first operation unit 76, and can be disassembled as shown in FIG.
It can be assembled as shown in. The unit portion 77 of the first treatment means and the outer sheath 71
Are detachably connected by a snap fit 79 provided at the proximal end of the distal tip 78 of the first treatment means unit portion 77. Both the outer sheath 71 of the insertion portion unit 75 and the first operation portion unit 76 are also detachably connected by a snap fit 80 provided at the proximal end of the outer sheath 71. further,
In the first treatment means unit section 77, the ball 82 provided at the proximal end of the operation shaft 81 is made into an engagement groove (not shown) formed at the working end of the movable operation lever 83 of the first operation section unit 76. The first treatment means can be operated by removably fitting and connecting the movable operation lever 83 with respect to the fixed lever 84. However, any connection method may be used. The movable operation lever 83 and the fixed lever 84
A ratchet mechanism 85 that locks at a position rotated in the closing direction is incorporated between the and.

Also in this third embodiment, the first and second
In the same manner as in the above embodiment, the unit parts of each group as shown in FIG. 3 are prepared to construct a system in which the parts can be replaced. As a result, the components of each unit can be arbitrarily combined and used, and as in the first and second embodiments described above, the efficiency of treatment and cost reduction can be achieved. In addition, the effects of cleaning / sterilization and damage to each part are
It has the same effect as the second embodiment.

In this embodiment, the number of hooks 72 is one.
However, the number of the hooks 72 may be any number and the shape thereof is not limited as long as it is within the range for the purpose of the present invention.

FIG. 10 shows a modified example of the endoscopic treatment tool 70. The major differences are as follows. That is, the outer sheath 71 of the insertion section unit is bent in the middle, and in the unit 76 of the first operating means, the movable operating lever 83 and the fixed lever 84 are arranged substantially parallel to the axial direction of the outer sheath 71. It is a grip type. An operation link mechanism 86 is provided between the movable operation lever 83 and the fixed lever 84. The operation link mechanism 86 is
A first lever 87 whose one end is pivotally attached to the movable operation lever 83.
And a second lever 88 having one end pivotally attached to the fixed lever 84.
The ball 82 provided at the proximal end of the operation shaft 81 of the unit portion 77 of the first treatment means is pivotally connected to each other end of It is designed to be connected to. The movable operation lever 83 has a spring 8
It is urged in the opening direction by 9. When the movable operation lever 83 is pushed to the end, the engagement is automatically released. Further, the gripping piece 7 of the first treatment means
7a is bent. This is also used in the same manner as described above by exchanging with other parts and having other functions systematically. The movable sheath 73 is made of a bendable material at least in the distal end tube portion. <Fourth Embodiment> A fourth embodiment of the present invention will be described with reference to FIGS. This embodiment is also an example of the same as the above-described embodiment, which is used in combination with the components of each group of the system shown in FIG. The basic structure of this is the same as that of the third embodiment, but in this endoscopic treatment tool 90, the distal end side portion 71a of the outer sheath 71 of the insertion section unit has a proximal end. It is thinner than the side portion 71b. An elastic hook 9 serving as a fixed second treatment means is provided on the outer circumference of the thin distal end side portion 71a.
1 is attached. The hook 91 is configured to have a height that fits within the depth of the step of the thin distal end side portion 71a.

Further, at the proximal end of the outer sheath 71, an operation knob 94 for rotating the insertion unit 93 about its axis is provided. The knob 94 is provided with a water supply port 96 for cleaning the lumen of the insertion section unit 93. When the endoscopic treatment tool 90 is used, for example, gas for insufflating the abdominal cavity is used. Is covered with a rubber stopper 97 to prevent leakage. Furthermore, the first
For the same reason, a rubber cap 98 is attached to the upper portion of the unit 76 of the operating means to block the opening of the portion of the unit portion 77 of the first operating means where the proximal end of the operating shaft 81 projects. There is.

Further, this endoscopic treatment tool 90 is shown in FIG.
As shown by, the unit portion 77 of the first treatment means and the second
The unit in which the hook 91 as the treatment means and the outer sheath 71 as the insertion section unit are integrated and the first operation section unit 76 are divided into respective unit parts and can be disassembled as shown in FIG. As shown by 11, it can be assembled. Further, the ball 8 provided at the proximal end of the operation shaft 81 of the first treatment section unit 77.
2 is a movable operation lever 83 of the first operation section unit 76.
Is removably fitted and connected to an engagement groove formed at the working end of the first operation means, and the first treatment means can be operated by rotating the movable operation lever 83 with respect to the fixed lever 84. it can. However, any connection method may be used. A ratchet mechanism 85 that locks at a position rotated in the closing direction is incorporated between the movable operation lever 83 and the fixed lever 84.

Then, such an endoscopic treatment tool 90 is used.
Is used when the thread is ligated in the body cavity as in the above-described embodiments. Also in the fourth embodiment, similarly to the first and second embodiments, a unit component of each group as shown in FIG. 3 is prepared and a system capable of selectively exchanging components with them is constructed. To do. As a result, it is possible to use the respective units in any combination, and it is possible to use the optimum treatment means according to the treatment situation.
As in the third to third embodiments, the efficiency of treatment and the cost reduction can be achieved. Further, the same effects as those of the first and second embodiments can be obtained with respect to effects such as cleaning / sterilization and damage to each part.

In this embodiment, as shown in FIG. 13, a plurality of hooks 91 may be attached to the outer circumference of the outer sheath 71 of the insertion section unit. This FIG.
In the case of the one shown by, the movable operation lever 83 and the fixed lever 8
4 is arranged substantially parallel to the axial direction of the outer sheath 71 of the insertion unit, and the outer sheath 71 is bent in the middle thereof. The unit portion 77 of the first treatment means is detachably attached to the distal end portion of the outer sheath 71 by the pin 99. <Fifth Embodiment> A fifth embodiment of the present invention will be described with reference to FIGS. This embodiment is also another example of the combination of the systems shown in FIG. 3 in the first embodiment described above. Of course, the basic configuration and the like of this are common to those of the above-described embodiments.

The feature of this embodiment is that the grasping forceps portion 10 of the first treatment means is provided at the distal end of the outer sheath 100 as an insertion portion.
1 is disposed, and the retraction element 102 of the second treatment means is provided in the lower portion of the distal end portion of the outer sheath 100 thereof. This expulsion element 102 is opened and closed by operating the operating lever 104 of the second operating means provided at the lower part of the member of the operating portion 103 as the first operating means provided at the proximal end of the outer sheath 100 back and forth. It is supposed to be done.
The expulsion element 102 pivotally attaches a plurality of blades 105 coaxially, and is normally closed within the width of the outer sheath 100, but by operating the operating lever 104 back and forth, FIG. It can be opened as shown in a). The operation portion 103 is provided with an operation knob 106 for operating the grasping forceps portion 101.

Conventionally, when a tissue (not shown) in a body cavity is peeled off, an endoscopic treatment tool for performing a peeling operation, a pressure eliminator for applying a tension to a portion to be peeled off, and for eliminating a disturbing tissue, etc. I needed more than two endoscopic instruments,
By using the endoscopic treatment tool as in this embodiment, it is possible to perform the treatment with one endoscopic treatment tool when performing the peeling operation.

The endoscopic treatment tool in this embodiment can be disassembled into unit parts as shown in FIG. That is, the outer sheath 100 of the insertion unit,
A first treatment unit 108 including the grasping forceps portion 101 and an operation shaft 107 thereof, a second treatment unit 110 including an excluding member 102 and an operation shaft 109 thereof, a first operation portion unit and a second operation portion. The unit is disassembled into the unit 113 and the unit 113, and these can be assembled as shown in FIG. The operation shafts 107 and 109 are adapted to be inserted into the holes formed in the outer sheath 100 as they are.

The first treatment unit 108 and the outer sheath 100 of the insertion section unit are snap-fit 1 provided at the distal end position of the first treatment unit 108.
It is connected in a detachable manner by 14. Further, the second treatment unit 110 and the outer sheath 10 of the insertion section unit.
0 is also detachably connected by a snap fit 115 provided at the distal end side position of the second treatment unit 110. The outer sheath 100 and the unit 113 of the operating portion are detachably connected by a cam lock 116 provided at the proximal end of the outer sheath 100. Furthermore, the first treatment unit 108
The operating section unit 113 and the first operation unit 108
Screw portion 118 provided at the proximal end of the operating shaft 107 of the
Is detachably connected by means of which the operation of the first operating means is performed by the grasping forceps part 1 of the first treatment unit 108.
I am trying to transmit it to 01. Further, the operation shaft 109 and the second operation means of the second treatment means include the engagement groove 119 provided at the proximal end of the operation shaft 109 of the second treatment unit 110 and the second operation means (not shown). It is detachably connected by engaging means. Then, the operation of the second operation unit is transmitted to the second treatment unit 110. It should be noted that these connecting means are merely examples, and any means may be used.

In this embodiment as well, the system shown in FIG. 3 is constructed in the same manner as in the above-mentioned embodiment, and, for example, the unit of each component shown in FIG. 15 is arbitrarily combined. Since it can be used, it has the same effects as the treatment efficiency and cost reduction as in the above-mentioned embodiment. Further, the effects related to the case where the treatment tool for endoscope is damaged and the cleaning and sterilization are similar to the above.

As described above, the shape and structure of the treatment tool for an endoscope of this embodiment may be of any type within the scope of the object of the present invention, and there is no particular limitation. <Sixth Embodiment> A sixth embodiment of the present invention will be described with reference to FIGS. This embodiment is another example of the combination of the systems shown in FIG. 3, like the above-mentioned embodiments. Of course, the basic configuration of this is the same as that of each of the above-described embodiments.

The feature of this embodiment is that the insertion unit 1
An electrode 122 as a second treatment means is arranged at the tip of 21. As the second treatment means, the high-frequency electrode 122 includes the outer sheath 123 of the insertion unit.
Treatment means disposed at the tip of the scissors, such as scissors forceps 124
It is arranged to be located on the lower side of. By using the high-frequency electrode 122 in combination with the scissors forceps 124, the tissue at the target site is efficiently cut and cauterized. Further, the scissors forceps 124 and the high-frequency electrode 122 are used as bipolar electrodes to perform high-frequency cauterization and the like.

As shown in FIG. 17, the treatment instrument for an endoscope of this embodiment has a first treatment unit 126 having scissors forceps 124 and an operating shaft 125 thereof, and a high-frequency electrode as second treatment means. It is possible to disassemble or assemble the insertion section unit 127, in which 122 and the outer sheath 123 are integrated, and the operation section unit 128.

Therefore, the first treatment unit 126 and the outer sheath 123 are detachably connected to each other by the screw portion 129 provided at the proximal end of the scissors forceps 124. Further, the unit 127 of the insertion portion and the operation portion unit 128 are fixed by a screw portion 129 provided on the operation portion unit 128, and are detachably attached so as to be released. Further, the first treatment unit 126 and the movable handle 131 of the first operation means incorporated in the operation unit unit 128 are the ball 132 provided at the proximal end of the operation shaft 125 and the rotating end of the movable handle 131. It is connected by being removably engaged with an engaging groove (not shown) provided in the above, and the operation of the first operating means is transmitted to the first treating means, but any connecting method may be used. Absent. Also,
The operation unit unit 128 includes a pair of energization pins 1 for energizing the high-frequency electrode 122 and the scissors forceps 124 with a high-frequency current.
33 are provided. These energizing pins 133 have
A pair of connectors (not shown) are individually connected to each other, and a high frequency current is supplied from a high frequency power source (not shown). As a result, during use, the high-frequency electrode 122 and the scissors forceps 12 are used.
A high-frequency current is supplied to 4 and.

Also in this embodiment, since a system for exchanging parts of each group as shown in FIG. 3 in the first embodiment can be constructed and various units can be used in combination, Similar to the first embodiment and the like, the efficiency of treatment and the cost reduction effect can be obtained. Further, the effects at the time of cleaning and sterilization and the effects when each part is damaged are the same as those in the above-mentioned embodiment. <Seventh Embodiment> A seventh embodiment of the present invention will be described with reference to FIGS. This embodiment is another example of the combination of the systems shown in FIG. 3, like the above-mentioned embodiments. Of course, the basic configuration of this is the same as that of each of the above-described embodiments.

The feature of this embodiment is that the insertion unit 1
The peeling forceps 143 as the first treatment means is arranged at the distal end of the outer sheath 142 of the outer sheath 41.
A laser probe 144 as a second treatment means is inserted into 2 and installed therein. This laser probe 14
4 is for performing a peeling operation or a hemostasis operation on the tissue of the target site together with the peeling forceps 143.

Generally, the laser peeling operation can be safely performed, but it is known that the laser light is absorbed when bleeding and it is difficult to obtain a satisfactory hemostatic performance. Has been. Therefore, the peeling forceps 1 capable of cauterizing by a high frequency current as in this embodiment.
Equipped with 43. As a result, safer separation and sufficient hemostasis performance can be obtained with a single endoscopic treatment tool.

The endoscopic treatment tool in this embodiment can be disassembled into units as shown in FIG. That is, the peeling forceps 143 and the operating shaft 14 thereof.
5, the first treatment unit 151, the unit 152 in which the laser probe 144 and the outer sheath 142 of the insertion unit are integrated, and the operation unit unit 153 for operating the first treatment unit 151 are disassembled separately. be able to. Further, these can be assembled in the state shown in FIG. Therefore, the first treatment unit 151
The outer sheath 142 and the outer sheath 142 are detachably connected by a snap fit 155 provided at the proximal end of the peeling forceps 143 of the first treatment unit 151, and the outer sheath 142 of the insertion section unit 141 and the operating section unit 15 are connected.
3 is fixed and detachably connected by a screw 156 provided on the upper portion of the member. Further, the peeling forceps 143 of the first treatment means and the operating movable handle 157 of the first operating means are formed on the ball 159 provided on the proximal end of the operating shaft 145 and on the movable handle 157. It is detachably connected by being fitted in the engagement groove which does not exist, and the operation of the movable handle 157 is transmitted to the part of the peeling forceps 143 via the operation shaft 145. And any connection method may be used.

Further, a laser irradiation switch 158 is provided as a second operating means on the lower front part of the member of the operation unit 153, and an induction pin 161 for high frequency ablation and a laser (not shown) are provided on the upper part of the member. A switch connector 162 that communicates with the main body of the irradiation device is provided. As a result, the laser irradiation operation, which is conventionally performed by using a foot switch or the like, can be performed by the operation section body of the endoscopic treatment tool.

Also in this embodiment, an exchange system for parts of each group as shown in FIG. 3 in the above-mentioned embodiment and the first embodiment is constructed, and various units are combined together. Can be used. Therefore, the efficiency of the plurality of treatments and the cost reduction effect can be obtained. The effects of cleaning, sterilization, and damage to each part are also the same as those in the above-mentioned embodiment. Also, the laser probe 14
4, the irradiation performance may be deteriorated when it is used for a long time, but in such a case, the unit 152 in which the laser probe 144 and the outer sheath 142 are integrated is replaced with a new one. As a result, the performance can be recovered without exchanging the entire endoscopic treatment tool, and the cost can be reduced. <Eighth Embodiment> An eighth embodiment of the present invention will be described with reference to FIGS. This embodiment is also an example of the combination of the systems shown in FIG. 3 in the first embodiment described above. Of course, the basic configuration and the like of this are the same as those of the above-described embodiment.

The feature of this embodiment is that the insertion unit 1
The outer sheath 171 of 70 is provided with a treatment hole 172, the distal end of which is located at the proximal end of the first treatment means unit 173 provided at the distal end of the outer sheath 171. And it is open. Further, the proximal end of the treatment hole 172 is connected so as to communicate with the treatment sheath 174, and in the vicinity of the first operating means unit 175 provided at the proximal end of the outer sheath 171 thereof, The cock 176 is attached, and the cock 176
A rubber stopper 177 is attached to the more proximal end portion.
With this cock 176 and the rubber stopper 177, the treatment hole 17
The gas in the abdominal cavity from 2 is prevented from flowing out. An energization pin 179 is provided on the upper part of the unit member of the first operation means unit 175, and a power supply cord (not shown) is connected to this to supply a high frequency current from a high frequency power source (not shown) to the body cavity through the first treatment means unit 173. The tissue in the body cavity can be cauterized by flowing it into the inner tissue.

As shown in FIG. 23, the treatment hole 172.
Various treatment means 182 can be inserted as the second treatment means and used. For example, selectively use a water supply / suction tube 183, a high-frequency electrode 184, an endoscopic treatment tool 185, a laser probe 186, a catheter 187, an ejector 188, and the like as shown in FIG. 24 according to the purpose of the treatment. In addition, any treatment means may be inserted into the treatment hole 172 and used as long as it is within the scope of the object of the present invention. There is no limit.

Further, in this embodiment, FIG. 21 and FIG.
2, the insertion unit 170, the first treatment means unit 173, and the first operation means unit 175.
It can be disassembled and can be reassembled. Therefore, the insertion section unit 170 and the first treatment means unit 173 are detachably connected by the snap fit 191 provided in the first treatment means unit 173, and the insertion section unit 1 is also attached.
70 and the first operating means unit 175 are, for example, an engaging hole 192 provided at the proximal end of the insertion section unit 170 as shown in FIG. 21 and an upper part of the member of the first operating means unit 175 as shown in FIG. Energizing pin 17 provided on the
Both are detachably connected by a screw (not shown) formed on the lower portion of the energizing pin 179 formed on the lower portion of the connector 9. The first treatment means unit 173 and the first operation means unit 175 are the same as the first treatment means unit 173.
194 provided on the proximal end of the operating shaft 178 of the
And the first operating means unit 175 is detachably connected by an engagement groove (not shown) provided in the first operating means unit 175.
It is transmitted to 73. Of course, any connection method may be used.

However, also in this embodiment, as shown in FIG.
As in the system shown in (1), by using various units in combination according to the situation, the efficiency of treatment and the cost reduction effect can be obtained as in the first embodiment described above.
Further, also in the case of cleaning / sterilization or a part of the treatment tool for an endoscope being damaged, the same effects as those of the above-mentioned respective embodiments can be obtained.

FIG. 23 is also an example of how to use this embodiment, but in this use example, the first treatment means unit 173 is used.
The shape of the grasping forceps part of the
The operation unit 175 is also equipped with a ratchet mechanism 195. As shown in FIG. 23, the treatment hole 1
A ligature 196 is inserted in 72, and a loop portion 197 at the distal end thereof is hooked on the first treatment means unit 173. Then, the loop portion 19 of the ligature 196
7 is hooked on the tissue to be ligated, the knob 198 provided at the proximal end is bent and cut off from the main body of the ligature tool 196, and the loop portion 197 is pulled by the proximal side.
And ligate the target tissue site. Conventionally,
This kind of ligature tool 196 was paired with grasping forceps and was inserted into the body cavity from different trocars to ligate the target tissue site. However, when the loop portion 197 is hung on the target tissue site, There is a problem that the loop portion 197 is bent, and in practice, it is difficult to hang the loop portion 197 on a target tissue site in the body cavity, and it is difficult to surely ligate it.

In this method of use, the target tissue site is first
While holding the treatment means unit 173, the ligature tool 196 is pressed against the grasped tissue site, the knob 198 is cut off from the main body of the ligature tool 196 and pulled to the proximal side, whereby the tissue can be surely ligated.

As described above, the number of fistulas for guiding an endoscopic treatment tool such as a treatment hole, a port, a trocar, etc. into the body cavity is desired to be improved in comparison with the conventional technique. Want to use a combination of multiple treatment functions systematically, to prevent an increase in medical costs due to the large number of treatment tools for endoscopes, and to have multiple treatment functions, and also to provide treatment holes, ports, and trocars. There is no limitation on the structure or the like as long as it is within the range in which the diameter of the same is not desired to be increased and the object of the present invention is met. [Supplementary Note] (Supplementary Note 1) In an endoscopic treatment tool used for treating a site inside a body cavity under an endoscope, at least one first operating means and the first operating means are connected. At least one insertion part to be inserted into a body cavity, and at least one first treatment means located at a distal end of the insertion part unit for treating a living tissue by operating the first operation means; At least one incorporated in the insert unit
A second treatment means, wherein the first treatment means and the unit of the insertion section are at least disassembleable and reassembling, and a system of a treatment instrument for endoscopes. (Supplementary Note 2) The system for an endoscopic treatment instrument according to Item (1), wherein the first operation means unit and the insertion unit unit can be disassembled and assembled. (Supplementary Note 3) The system of the treatment instrument for endoscope according to the above (1) or (2), wherein the insertion section unit and the second treatment means unit can be disassembled and assembled. . (Supplementary Note 4) At least one second operation means unit for operating the second treatment means unit is provided in the insertion section unit, and the insertion section unit and the second treatment means unit are The endoscopic treatment instrument system according to (1), (2), (3), wherein the system can be disassembled and assembled. (Supplementary Note 5) In an endoscopic treatment tool used for treatment of a body cavity under an endoscope, at least one first operation means unit for operating the endoscopic treatment tool, and the first operation. At least one inserter unit connected to the means unit for guiding the endoscopic treatment tool into the body cavity or the endoscope; and a first end located at the distal end of the inserter unit.
At least one first treatment means unit for treating a living tissue by operating the operation means unit,
The insertion section unit has at least one treatment hole for guiding at least one second treatment means into a body cavity or an endoscope, and the insertion section unit and the first treatment means unit are disassembled and assembled. A system of a treatment tool for an endoscope, which is characterized in that it is possible. (Supplementary note 6) The system for an endoscopic treatment instrument according to the above item (5), wherein the insertion section unit and the first operation means unit can be disassembled and assembled. (Supplementary Note 7) In a treatment tool for an endoscope used for treating a site inside a body cavity under an endoscope, a plurality of types of unit groups that are selected and serve as at least two operating means are selected. A plurality of types of unit groups that are insertion unit units that are selected to be connected to the operating means and are inserted into the body cavity,
A plurality of types of unit groups, which are located at the distal end of the selected insertion unit and are selected to perform a treatment on a biological tissue by operating one of the operation unit, and which are first treatment units; At least one second treatment means unit to be incorporated in the selected insertion unit unit, wherein the first treatment means unit and the insertion unit unit can be disassembled and assembled at least. System of treatment instruments for endoscopes. (Supplementary Note 8) The endoscopic treatment according to any one of (3 to 7) above, wherein the selected operation means unit and the selected insertion unit unit can be disassembled and assembled. Tool system.

These are problems of the prior art,
The procedure is not efficient, there are many holes for guiding the treatment instruments for endoscopes such as treatment holes, ports and trocars into the body cavity, many treatment functions cannot be systematically combined, and many The present invention intends to solve the problems that medical costs tend to increase by arranging endoscopic treatment tools, and that the diameters of treatment holes, ports, trocars, and the like cannot be reduced.

[0077]

As described above, according to the present invention, it is possible to reduce the number of insertion holes, ports, trocars or the like for introducing the treatment instrument for an endoscope into a body cavity, and to provide a plurality of treatment functions. Can be used in combination systematically, the surgical work is inefficient, and
It is possible to provide an endoscopic treatment instrument of an economical system capable of suppressing an increase in medical equipment cost due to the arranging of a large number of endoscopic treatment instruments.

[Brief description of drawings]

FIG. 1 is a side view of an example endoscopic treatment tool according to a first embodiment of the present invention.

FIG. 2 is a side view showing the disassembled state of the endoscopic treatment tool according to the first embodiment of the present invention.

FIG. 3 is an explanatory diagram of a parts replacement system for a treatment tool for an endoscope according to the first embodiment of the present invention.

FIG. 4 is an explanatory view of a usage state of another example of the endoscopic treatment tool according to the first embodiment of the present invention.

FIG. 5A is a side view of an example endoscopic treatment tool according to a second embodiment of the present invention, and FIG. 5B is a plan view of the endoscopic treatment tool.

FIG. 6 is a side view showing the disassembled state of the endoscopic treatment tool according to the second embodiment of the present invention.

FIG. 7 is an explanatory view of another example of the endoscopic treatment tool.

FIG. 8 is a side view of an example of an endoscopic treatment tool according to a third embodiment of the present invention.

FIG. 9 is a side view showing the disassembled state of the endoscopic treatment tool according to the third embodiment of the present invention.

FIG. 10 is a side view of a modified example of the endoscopic treatment tool in the embodiment, in a disassembled state.

FIG. 11 is a side view of an example of an endoscopic treatment tool according to a fourth embodiment of the present invention.

FIG. 12 is a side view showing the disassembled state of the endoscopic treatment tool according to the fourth embodiment of the present invention.

FIG. 13 is a side view showing another disassembled state of the endoscope treatment tool of the present invention.

FIG. 14 is a side view of an example of an endoscopic treatment tool according to a fifth embodiment of the present invention.

FIG. 15 is a side view showing the disassembled state of the endoscopic treatment tool according to the fifth embodiment of the present invention.

FIG. 16 is a side view of an example of an endoscopic treatment tool according to a sixth embodiment of the present invention.

FIG. 17 is a side view of the endoscopic treatment tool in a disassembled state according to the sixth embodiment of the present invention.

FIG. 18 is a side view of an example of an endoscopic treatment tool according to a seventh embodiment of the present invention.

FIG. 19 is a side view of the endoscopic treatment tool in a disassembled state according to the seventh embodiment of the present invention.

FIG. 20A is a side view of an example endoscopic treatment tool according to an eighth embodiment of the present invention, and FIG. 20B is a plan view of the endoscopic treatment tool.

FIG. 21 is a side view of the disassembled partial component of the endoscopic treatment tool according to the eighth embodiment of the present invention.

FIG. 22 is a side view of the remaining disassembled parts of the endoscopic treatment tool according to the eighth embodiment of the present invention.

FIG. 23 (a) is a side view of an endoscope treatment tool of another example in the eighth embodiment of the present invention, and FIG. 23 (b) is a plan view of the endoscope treatment tool.

FIG. 24 is an explanatory diagram of a parts replacement system for an endoscopic treatment tool according to an eighth embodiment of the present invention.

FIG. 25A is a side view of a conventional endoscopic treatment tool;
(B) is sectional drawing which follows the AA line in (a).

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Endoscopic treatment tool, 2 ... Outer sheath, 3 ... 1st treatment means unit, 4 ... 2nd treatment means unit, 5 ... 1st operation means unit, 6 ... 2nd operation means unit, 11 ... Operation shaft , 12 ... Tip member, 13 ... Forceps, 15 ... Engagement groove (snap fit), 16 ... Connecting end, 17 ... Fixed handle, 18 ... First movable handle, 19 ... Movable handle, 2
1 ... Fixing screw, 26 ... Grasping forceps, 27 ... High frequency electrode, 2
8a, 28b, 28c ... Operation means unit.

─────────────────────────────────────────────────── ───

[Procedure amendment]

[Submission date] March 7, 1995

[Procedure Amendment 1]

[Document name to be amended] Statement

[Correction target item name] 0041

[Correction method] Change

[Correction content]

Therefore, with the above configuration, the above-mentioned first
Similar to the embodiment described above, each part can be surely cleaned and sterilized, and in particular, the water supply / suction pipe and the valve 54 through which blood and the like in the body cavity circulate can be disassembled. Cleaning and sterilization can be performed reliably.

[Procedure Amendment 2]

[Document name to be amended] Statement

[Correction target item name] 0053

[Correction method] Change

[Correction content]

In this embodiment, as shown in FIG. 13, a plurality of hooks 91 may be attached to the outer circumference of the outer sheath 71 of the insertion section unit. This FIG.
In the case of the one shown by, the movable operation lever 83 and the fixed lever 8
4 is arranged substantially parallel to the axial direction of the outer sheath 71 of the insertion unit, and the outer sheath 71 is bent in the middle thereof. The unit portion 77 of the first treatment means is detachably attached to the distal end portion of the outer sheath 71 by the pin 99. <Fifth Embodiment> A fifth embodiment of the present invention will be described with reference to FIGS. This embodiment is also another example of the combination of the systems shown in FIG. 3 in the above-mentioned first embodiment. Of course, the basic configuration and the like of this are common to those of the above-described embodiments.

[Procedure 3]

[Document name to be amended] Statement

[Correction target item name] 0075

[Correction method] Change

[Correction content]

As described above, the number of fistulas for guiding an endoscopic treatment tool such as a treatment hole, a port, a trocar, etc. into the body cavity is desired to be improved in comparison with the conventional technique. Want to use a combination of multiple treatment functions systematically, to prevent an increase in medical costs due to the large number of treatment tools for endoscopes, and to have multiple treatment functions, and also to provide treatment holes, ports, and trocars. There is no limitation on the structure or the like as long as it is within the range in which the diameter of the same is not desired to be increased and the object of the present invention is met. [Supplementary Note] (Supplementary Note 1) In an endoscopic treatment tool used for treating a site inside a body cavity under an endoscope, at least one first operating means and the first operating means are connected. At least one insertion part to be inserted into a body cavity, and at least one first treatment means located at a distal end of the insertion part unit for treating a living tissue by operating the first operation means; At least one incorporated in the insert unit
A second treatment means, wherein the first treatment means and the unit of the insertion section are at least disassembleable and reassembling, and a system of a treatment instrument for endoscopes. (Supplementary Note 2) The system for an endoscopic treatment instrument according to Item (1), wherein the first operation means unit and the insertion unit unit can be disassembled and assembled. (Supplementary Note 3) The system of the treatment instrument for endoscope according to the above (1) or (2), wherein the insertion section unit and the second treatment means unit can be disassembled and assembled. . (Supplementary Note 4) At least one second operation means unit for operating the second treatment means unit is provided on the proximal end side of the insertion section unit, and the insertion section unit and the second treatment are provided. The means unit and the first (1, 2, 3), characterized in that they can be disassembled and assembled.
The system of the treatment tool for endoscopes according to the item. (Supplementary Note 5) In an endoscopic treatment tool used for treatment of a body cavity under an endoscope, at least one first operation means unit for operating the endoscopic treatment tool, and the first operation. At least one inserter unit connected to the means unit for guiding the endoscopic treatment tool into the body cavity or the endoscope; and a first end located at the distal end of the inserter unit.
At least one first treatment means unit for treating a living tissue by operating the operation means unit,
The insertion section unit has at least one treatment hole for guiding at least one second treatment means into a body cavity or an endoscope, and the insertion section unit and the first treatment means unit are disassembled and assembled. A system of a treatment tool for an endoscope, which is characterized in that it is possible. (Supplementary note 6) The system for an endoscopic treatment instrument according to the above item (5), wherein the insertion section unit and the first operation means unit can be disassembled and assembled. (Supplementary Note 7) In a treatment tool for an endoscope used for treating a site inside a body cavity under an endoscope, a plurality of types of unit groups that are selected and serve as at least two operating means are selected. A plurality of types of unit groups that are insertion unit units that are selected to be connected to the operating means and are inserted into the body cavity,
A plurality of types of unit groups, which are located at the distal end of the selected insertion unit and are selected to perform a treatment on a biological tissue by operating one of the operation unit, and which are first treatment units; At least one second treatment means unit to be incorporated in the selected insertion unit unit, wherein the first treatment means unit and the insertion unit unit can be disassembled and assembled at least. System of treatment instruments for endoscopes. (Supplementary Note 8) The endoscopic treatment according to any one of (3 to 7) above, wherein the selected operation means unit and the selected insertion unit unit can be disassembled and assembled. Tool system.

[Procedure amendment 4]

[Document name to be amended] Statement

[Correction target item name] 0077

[Correction method] Change

[Correction content]

[0077]

As described above, according to the present invention, it is possible to reduce the number of insertion holes, ports, trocars or the like for introducing the treatment instrument for an endoscope into a body cavity, and to provide a plurality of treatment functions. and can be used in combination systematically, surgical operations is ability factor, the addition, of economical system which can suppress the increase in medical equipment cost due to align the number of the endoscope treatment tool A treatment tool for an endoscope can be provided.

Claims (1)

[Claims] 1. A treatment tool for an endoscope used for treating a site inside a body cavity under an endoscope, comprising: at least one first operating means unit; and a body operating inside the body cavity connected to the first operating means. At least one insertion section unit to be inserted; at least one first treatment means located at a distal end of the insertion section unit for performing treatment on living tissue by operating the first operation means unit; At least one second treatment means unit incorporated in the insertion section unit, wherein the first treatment means unit and the insertion section unit can be disassembled and assembled at least. Ingredient