JPH10151143A - Hot biopsy clamp for endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To facilitate hemostatis after a polyp is cut off by a high frequency by specifying a maximum opening width of the tip of a pair of clamp cups in a subject clamp where a pair of clamp cups which are connected to a high frequency power source and are opened and closed by remote control, are inserted into a tip part of a clamp channel of an endoscope. SOLUTION: A flexible shaft part is inserted into a clamp channel of an endoscope, and the affected part of a living body is treated by a tip part 10b of a clamp. In this case, a pair of clamp cups 17 are opened and closed by moving an operation wire in the axial direction by operating a slider in an operation part. A main body of the tip part 10b is composed of a link mechanism 19 containing a pair of parallel arms and a cylindrical part connected to the tip of a coil pipe 13, and a pair of clamp cups 17 are pivoted on a tip side part of the link mechanism 19. These clamp cups 17 are formed so that a maximum opening width W on its tip becomes 2 to 3mm, and a maximum opening angle θ of the clamp cups 17 to the central axis is set to 10 to 30 deg..

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a hot biopsy forceps for an endoscope in which a high-frequency current for treatment can be applied to a forceps cup of a biopsy forceps for an endoscope.

[0002]

2. Description of the Related Art A biopsy forceps for an endoscope has a pair of forceps cups at its distal end which are driven to open and close by a link mechanism operated by remote control from a hand side, and is inserted into a forceps channel of the endoscope. Used.

[0003] A hot biopsy forceps for an endoscope can cauterize mucous tissue damaged at the time of collecting a biopsy tissue by applying a high-frequency current to a forceps cup of such a biopsy forceps, thereby preventing bleeding. It is like that.

[0004]

A so-called high-frequency snare formed in a loop by a conductive wire is used for resection of a polyp in a body cavity, but the resection is performed in a state where cauterization by a high-frequency current is insufficient. In some cases, bleeding may occur from the stump.

[0005] Since blood vessels are generally harder than the mucosal surface, the blood vessels protrude several millimeters at the stump after polyp resection, and when the bleeding from such a part is stopped endoscopically, the hot biopsy forceps is used. Used.

FIG. 11 shows a state in which the cut end of the blood vessel 100 protrudes from the stump of the stalk 101 after the polyp is excised, and the forceps cup 90 of the opened hot biopsy forceps is moved from the distal end side. It is in a state of seeing.

[0007] From such a state, a pair of forceps cup 9
0, the forceps cup 90
When a high-frequency current is applied to the blood vessel, the blood vessel 100 can be cauterized and coagulated in a state where the cut portion is closed, thereby stopping the blood.

[0008] As a hemostatic device, there are a device that irradiates a laser beam and a device that presses a high-frequency electrode. However, if the bleeding site is covered with blood, it is extremely difficult to perform an accurate hemostatic treatment. A hot biopsy forceps for an endoscope that can remove and cauterize the blood vessel 100 can perform hemostasis very safely and reliably.

However, the forceps cup of the hot biopsy forceps for an endoscope is generally opened to about 90 ° to 100 °, and the opening width of the tip at that time is about 5 mm to 7 mm, and as shown in FIG. Stalk 10
In many cases, the diameter spreads more than one diameter.

Therefore, when the forceps cup 90 is closed from this state, the forceps cup 90 tends to sandwich the stalk 101 of the polyp, so that the blood vessel 100 cannot be sandwiched by the forceps cup 90.

Further, depending on the state of the stump, for example, FIG.
As shown in FIG. 2, one of the pair of forceps cups 90 is hooked on the stem 101, and the other is closed past the blood vessel 100 as shown by the arrow A, and the blood vessel 100 is closed with the forceps cup 90. In some cases, it cannot be pinched.

Accordingly, an object of the present invention is to provide a hot biopsy forceps for an endoscope, which can easily and surely pinch a blood vessel or the like at a bleeding site after a high frequency resection of a polyp to stop blood.

[0013]

In order to achieve the above object, a hot biopsy forceps for an endoscope according to the present invention is connected to a high frequency power supply and driven by a remote operation from a hand side to open and close a pair of forceps cups. The end portion of the pair of forceps cups has a maximum opening width of 2 mm to 3 mm in a hot biopsy forceps for an endoscope which is used by being inserted into a forceps channel of an endoscope. I do.

[0014] The maximum opening angle of the forceps cup is preferably 10 ° to 30 ° with respect to the center axis, and further, tooth-like irregularities may be formed at the edge of the forceps cup.

It is preferable that the engaging surface of the edge of the forceps cup has a width of 0.1 mm to 0.5 mm, but the engaging portion of the edge of the forceps cup is formed to be sharp. May be.

[0016]

Embodiments of the present invention will be described with reference to the drawings. FIG. 2 shows a state in which the hot biopsy forceps 10 is used through the endoscope 1, and the flexible shaft portion 10a of the hot biopsy forceps 10 is shown.
Is inserted into the forceps channel 1 a of the endoscope 1, and a treatment of an affected part in the body of the patient 200 is performed by the distal end portion 10 b of the hot biopsy forceps 10.

A patient electrode plate 3 having a large contact area is brought into contact with the patient 200. The patient electrode plate 3 is provided between the operation unit 10c provided on the hand side of the hot biopsy forceps 10 and the high-frequency power supply device 2 and the patient electrode plate 3 And the high-frequency power supply 2
They are connected by electric cords 4 and 5, respectively. 6 is
This is a grounding cord for making the endoscope 1 have the same potential as the patient electrode plate 3.

FIG. 3 shows the hot biopsy forceps 10, in which the operation wire passed through the shaft portion 10a so as to be able to advance and retreat moves in the axial direction by moving the slider 11 arranged on the operation portion 10c. And the tip 1
The forceps cup provided in Ob opens and closes.

A connector 12 to which the electric cord 6 is connected is provided on the slider 11, and is electrically connected to a forceps cup at the distal end portion 10b via an operation wire.
Therefore, a high-frequency current is supplied from the high-frequency power supply device 2 to the forceps cup at the distal end portion 10b.

FIG. 4 shows the tip 10b of the hot biopsy forceps 10. Reference numeral 13 denotes a tightly wound coil pipe which constitutes the shaft portion 10a over the entire length, and an outer peripheral surface thereof is covered with an electrically insulating outer tube 14. Reference numeral 15 denotes an operation wire.

The body 16 of the distal end portion 10b comprises a pair of parallel arm-shaped link mechanism supporting portions 16a and a cylindrical portion 16b connected to the distal end of the coil pipe 13.

A pair of forceps cups 17 are rotatably supported by a support shaft 18 at the distal end portion of the link mechanism support portion 16a. A link mechanism 19 for opening and closing the forceps cup 17 is provided with a link. It is arranged in the mechanism support 16a.

The distal end of the operation wire 15 inserted in the coil pipe 13 so as to be able to advance and retreat in the axial direction is connected to a link mechanism 19.
When the operation wire 15 is operated forward and backward, the link mechanism 19 operates in a pantograph shape, and the forceps cup 17 is opened and closed.

A plurality of grooves 17a are formed at the edges of the pair of forceps cups 17 arranged opposite to each other at appropriate intervals in a direction perpendicular to the axis, whereby the forceps cup 17 The edge is formed in the shape of a crocodile mouth.

FIG. 1 shows a state in which the forceps cup 17 is fully opened, the maximum opening width W of the tip of the forceps cup 17 is 2 mm to 3 mm, and the maximum opening of the forceps cup 17 with respect to the center axis. Angle θ is 10 ° to 30 °
Is set to

FIG. 5 schematically shows a state in which the blood vessel 100 is sandwiched between the forceps cup 17. Assuming that a force applied to the blood vessel 100 in the closing direction of the forceps cup 17 is F, f = F. tan
The force of θ is applied in a direction in which the blood vessel 100 is pushed out from between the forceps cups 17. In order to prevent the blood vessel 100 from slipping out between the pair of forceps cups 17, it is better that f is small.

FIG. 6 shows that θ = 45 °, θ = 30 ° and θ =
The force F by which the forceps cup 17 presses the blood vessel 100 and the force f by which the forceps cup 17 pushes out the blood vessel 100 are illustrated in each case of 15 °.

When θ = 45 °, f = F, and the blood vessel 1
00 is large, so forceps cup 1
When the blood vessel 100 is picked up in step 7, the blood vessel 100 is
Easy to slide out between.

When θ = 30 °, f = 0.58 · F, and the force for pushing out the blood vessel 100 is reduced to about half of the force for pushing the blood vessel 100, which is 58%. Then, once the blood vessel 100 is pressed by the forceps cup 17, the blood vessel 100 is crushed by the forceps cup 17 until θ = about 20 ° as shown in FIG.

Then, when θ = 20 °, f = 0.36
F, the force for pushing out the blood vessel 100 is reduced to about one third of the pressing force. Therefore, the blood vessel 100
Does not slide out from between the forceps cups 17.

When θ = 15 °, f = 0.27 · F, and the force for pushing out the blood vessel 100 is reduced to nearly one-fourth of the pressing force. It can be reliably held in between.

Therefore, the maximum opening angle θ of the forceps cup 17 with respect to the center axis is preferably set to 30 ° or less.
However, if θ is made too small, disadvantageous surfaces such as the length of the forceps cup 17 becoming too long to obtain a required opening width appear, so that θ is preferably set to 10 ° or more.

FIG. 8 shows the stem 1 after the polyp has been excised.
01 is inserted into the forceps cup 17
Shows a state in which the maximum opening width W of the pair of forceps cups 17 is 3 mm and the blood vessel 100 having a diameter of about 1 mm is to be removed.

If the maximum opening width of the forceps cup 17 does not exceed 3 mm, the stalk 101 from which the polyp has been cut is hardly pinched by the forceps cup 17, and the forceps cup 17 Since there is not too much gap between the blood vessel 17 and the blood vessel 100, the blood vessel 100 can be easily grasped.

When the bleeding blood vessel 100 is gripped by the forceps cup 17, a high-frequency current is applied to the forceps cup 17, so that the cut portion of the blood vessel 100 can be cauterized and coagulated to stop bleeding.

When aiming to sandwich the blood vessel 100 between the pair of forceps cups 17, a certain gap is required between the opened forceps cup 17 and the blood vessel 100. If the gap is too small, it becomes difficult to pinch the blood vessel 17.

Therefore, the maximum opening width W of the forceps cup 17 is preferably set to 2 mm or more, and if it is set to 3 mm, the blood vessel 100 having a diameter of about 2 mm can be easily picked.

FIGS. 9 and 10 show a hot biopsy forceps for an endoscope according to a second embodiment of the present invention.
The tip portion of the forceps cup 17 is formed to be thin. As shown in the plan partial sectional view of FIG. 10, the engagement surface 17b of the edge of the forceps cup 17 is, for example, 0.1 mm.
It has a flat surface with a width of 1 mm to 0.5 mm so as not to cut the blood vessel 100 to be picked.

The present invention is not limited to the above embodiments. For example, the forceps cup 17 does not necessarily need to be provided with the groove 17a.
The edge of the forceps cup 17 may be formed sharp.

[0040]

According to the present invention, by setting the maximum opening width of the tip of the pair of forceps cups to 2 mm to 3 mm, the bleeding site after high-frequency resection of the polyp is improved.
The bleeding source blood vessel or the like can be easily and reliably sandwiched by the forceps cup to stop the bleeding without being caught on the stem.

Further, by setting the maximum opening angle of the forceps cup to 10 ° to 30 ° with respect to the central axis, it becomes difficult for the blood vessel to slide out between the pair of forceps cups, so that the blood vessel can be more easily and reliably picked. it can.

[Brief description of the drawings]

FIG. 1 is a partial side sectional view of a distal end portion of a hot biopsy forceps for an endoscope according to a first embodiment of the present invention with a forceps cup opened.

FIG. 2 is an overall schematic view of a system using the hot biopsy forceps for an endoscope according to the first embodiment of the present invention.

FIG. 3 is an overall external view of a hot biopsy forceps for an endoscope according to the first embodiment of the present invention.

FIG. 4 is a partial side sectional view of a distal end portion of the hot biopsy forceps for an endoscope according to the first embodiment of the present invention in a state where a forceps cup is closed.

FIG. 5 is a schematic view of a forceps cup portion for explaining a function of the first embodiment of the present invention.

FIG. 6 is a diagram for explaining functions of the first embodiment of the present invention.

FIG. 7 is a schematic sectional view of a blood vessel for explaining a function of the first embodiment of the present invention.

FIG. 8 is a cross-sectional view of a portion to be treated for explaining the operation of the first embodiment of the present invention.

FIG. 9 is a partial side sectional view of a distal end portion of an endoscope hot biopsy forceps according to a second embodiment of the present invention.

FIG. 10 is a plan partial cross-sectional view of a distal end portion of an endoscope hot biopsy forceps according to a second embodiment of the present invention.

FIG. 11 is a cross-sectional view of a portion to be treated for explaining the operation of a conventional hot biopsy forceps for an endoscope.

FIG. 12 is a cross-sectional view of a portion to be treated for explaining the operation of a conventional endoscope hot biopsy forceps.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Endoscope 1a Forceps channel 2 High frequency power supply device 10 Hot biopsy forceps 10a Shaft section 10b Tip section 17 Forceps cup 100 Blood vessel

Claims (5)

[Claims] An endoscope having a pair of forceps cups connected to a high-frequency power source and driven to be opened and closed by remote operation from a hand side at an end portion thereof and used by being inserted into a forceps channel of an endoscope. A hot biopsy forceps for an endoscope, wherein the maximum opening width of the pair of forceps cups is 2 mm to 3 mm. 2. The hot biopsy forceps for an endoscope according to claim 1, wherein the maximum opening angle of the forceps cup is 10 ° to 30 ° with respect to a central axis. 3. The hot biopsy forceps for an endoscope according to claim 1, wherein the forceps cup has tooth-shaped irregularities formed at an edge thereof. 4. An engaging surface of an edge portion of the forceps cup,
3. The method according to claim 1, wherein the width is 0.1 to 0.5 mm.
Or a hot biopsy forceps for an endoscope according to 3; 5. A hot biopsy forceps for an endoscope according to claim 1, wherein an engaging portion of an edge of said forceps cup is formed sharp.