JPS61257639A - High frequency inciser - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to a high-frequency incision tool that is inserted endoscopically into a body cavity to incise the duodenal papilla and the like.

[Prior Art] For example, a high-frequency incision tool is known that uses high frequency to incise the duodenal papilla when the duodenal papilla is obstructed.

For example, as shown in Japanese Unexamined Patent Publication No. 60-29141, a knife wire is exposed along the outer surface near the tip of a flexible tube that can be inserted into an insertion channel of an inner bowl mirror. A high-frequency incision is formed at the exposed portion of the knife wire, and a high-frequency incision is made in the papilla of the duodenum, for example, by passing a high-frequency current for cauterization to the incision through the knife wire. It has become. In this case, the tip of the flexible tube is inserted into the bile duct, and in order to confirm that the tip of the flexible tube is inserted into the bile duct, bile is aspirated through the flexible tube. is taking. - Therefore, an opening is provided in the side wall near the tip of the flexible tube, and bile is sucked through this opening, but in order to prevent the flexible tube from bending at this tip, a reinforcing wire is installed inside to prevent the flexible tube from bending. are doing.

[Problem that the invention seeks to solve]

In the prior art, the reinforcing wire provided to reinforce the distal end of the flexible tube can break when it is bent by an operation such as raising the forceps of an endoscope. There is a risk that this broken reinforcing wire may fall into the body cavity through the opening at the distal end of the flexible tube or the opening provided in the side wall.

This invention was made with attention to such a problem, and even if the reinforcing wire that reinforces the vicinity of the distal end of a flexible tube having an incision is broken in the middle, it will not fall off from the flexible tube. , aiming to improve safety.

[Means and effects for solving the problem] This high-frequency incision tool exposes an incision 6 for cauterization on the outer surface near the tip of the insulating flexible tube 1, and applies a high-frequency current to the incision 6. In a device that applies electricity to incise the papilla of the duodenum, etc., a stopper 9a@ is provided at the tip of a reinforcing wire 9 that reinforces the vicinity of the tip of the flexible tube 1, and the reinforcing wire 9 is inserted by bending the flexible tube 1.
Even if it breaks in the middle, it is held within the flexible tube 1 by the stopper 9a and is prevented from falling out of the flexible tube 1.

〔Example〕

Hereinafter, each embodiment of this invention will be described based on the drawings.

1 to 4 show a first embodiment, and FIG. 1 shows the overall structure of a high-frequency cutting tool. Reference numeral 1 denotes a flexible tube made of an electrically insulating material, and the flexible tube 1 can be inserted into an insertion channel of an endoscope, which will be described later.

A hand operation section 3 is connected to the proximal end of the flexible tube 1 via a suction section 2.
are connected to each other, and this hand operation section 3 is provided with a slider 4 for pushing and pulling a knife wire, which will be described later.

The slider 4 is electrically connected to a high frequency generator (not shown) for supplying high frequency current by a cord (not shown). Further, a suction device (not shown) such as a syringe is connected to the suction unit 2, and suction is performed through the flexible tube 1.

Furthermore, an incision 6 is provided near the tip of the flexible tube 1 by exposing a part of the knife wire 5 housed in the flexible tube 1 to the outside of the flexible tube 1. This incision 6 has two lead-out holes 8 formed in one side wall of the flexible tube 1 spaced apart in the front-rear direction for the knife wire 5 whose one end is fixed to the wire attachment tube 7 fixed inside the flexible tube 1. .8 to the outside of the flexible tube 1 and exposed. Roughly speaking, a reinforcing wire 9 is fixed to the wire attachment tube 7 so as to extend in the axial direction of the flexible tube 1 and to reinforce the flexible tube 1 near the incision 6. The tip of this reinforcing wire 9 has [
A wide stopper 9a is formed by bending the reinforcing wire 9 into a substantially U-shape, so that even if the reinforcing wire 9 is broken halfway, it will not fall out from the tip opening 1a and the opening 11, which will be described later. Furthermore, a plurality of markings 10 are provided at equal intervals on the outer surface of the flexible tube 1 in the vicinity of the incision 6.

Furthermore, a tip opening 1a is provided at the tip of the flexible tube 1, and the incision 6 near the tip
A suction opening 11 is provided on the side. Further, a reinforcing member 12 made of a metal pipe is attached to the inner wall of the flexible tube 1 corresponding to the opening 11. This reinforcing member 12
An opening 13 is provided in the flexible tube 1 by a cutout hole facing the opening 11 of the flexible tube 1, so that bile can be sucked through the opening 11.

Next, the operation of the high-frequency incision tool configured as described above will be explained.

First, a high-frequency cutting tool is inserted into the insertion channel of the endoscope 14 and inserted into the body cavity, and the distal end component 15 of the endoscope 14 is inserted into the body cavity.
The distal end of the flexible tube 1 is made to protrude from. And flexible tube 1
Insert the tip of the bile duct C through the papilla of the duodenum a. Here, a suction device such as a syringe is attached to the suction unit 2, and bile is suctioned from the opening 11 through the flexible tube 1, and the endoscope 14 confirms that it is bile. Check that it has been inserted. At this time, the vicinity of the incision 6 of the flexible tube 1 is bent, and even if the reinforcing wire 9 installed inside is cut from the middle due to this bending, there is a stopper larger than the tip opening 1a and the opening 11 at the tip of the reinforcing wire 9. 9a prevents the reinforcing wire 9 from falling out of the flexible tube 1 into the body cavity.

Next, when the slider 4 provided on the hand control unit 3 is pulled, the knife wire 5 is pulled, the incision 6 becomes straight and comes into contact with the nipple, and the flexible tube 1 curves. In this state, when the high frequency generator is operated to supply a high frequency current, the nipple can be incised with high frequency. In addition, at this time, if the flexible tube 1 is mistakenly inserted into the pancreatic duct d, no bile will be aspirated even if it is suctioned with an aspirator, and it can be confirmed that the flexible tube 1 is not inserted into the bile duct C. It is possible to confirm whether the insertion site is incorrect before applying high-frequency current, and to prevent the risk of making an incision at a site other than the intended site.

FIG. 5 shows a second embodiment, in which a pipe-shaped stopper 16 that is inserted into the flexible tube 1 is provided at the tip of the reinforcing wire 9.

FIG. 6 shows a third embodiment, in which a stopper 17 is formed by bending the tip of a reinforcing wire 9 into a substantially S-shape to provide elasticity.
This elastic force causes the tip to bite into the inner surface of the flexible tube 1, so that even if the reinforcing wire 9 is cut from the middle, the cut piece does not move and falls out of the flexible tube 11. This prevents

FIG. 7 shows a fourth embodiment. For the same purpose as the third embodiment, the tip of the reinforcing wire 9 is bent into a loop shape to form an elastic stopper 18. is inserted into the inner surface of the flexible tube 1.

(Effects of the Invention) As described above, according to the present invention, a stopper is provided at the tip of the reinforcing wire that reinforces the vicinity of the tip of a flexible tube having an incision, and the bending of the flexible tube strengthens the inside. Even if the wire is cut from the middle, it will not fall out into the body cavity outside the flexible tube, resulting in an effect that safety can be improved.

[Brief explanation of drawings]

1 to 4 show a first embodiment of the present invention, in which FIG. 1 is an overall view of the high-frequency cutting instrument, FIG. 2 is a vertical cross-sectional side view of its tip, and FIGS. 3 and 4. 5 is a longitudinal cross-sectional view of the distal end of the flexible tube showing the second embodiment; FIG. 6 is a longitudinal cross-sectional view of the distal end of the flexible tube showing the third embodiment. The side view and FIG. 7 are longitudinal sectional side views of the distal end portion of the flexible tube showing the fourth embodiment. DESCRIPTION OF SYMBOLS 1... Flexible tube, 2... Suction part, 3... Hand operation part, 5... Knife wire, 6... Incision part, 9... Reinforcement wire, 9a, 16.17. 18...Stopper, 1
1...Opening. Applicant's representative Patent attorney Atsushi Tsuboi Figure 5 Figure 6 Figure 1 Procedural amendments Showa 6i°2°^2 Day 1 Commissioner of the Patent Office Uga Michi Department □Tono 1, Indication of case Patent application No. 100972, 1986 2. Name of the invention: High-frequency cutting device 3. Relationship with the person making the amendment: Patent applicant (037) Olympus Optical Industry Co., Ltd. 4, Agent: 17th Mori Building, 1-26-5 Toranomon, Minato-ku, Tokyo.
Go to 1. 6. Target of correction 7. Contents of correction (1) "Intraradial vision" in the second line from the bottom of the first page of the specification is corrected to "transendoscopy." (2) Correct "-bidenal papilla I" in the third line of page 2 of the specification to "bile duct." (3) “To confirm,” on page 2, line 16 of the specification,
" should be corrected to "as a method of confirmation." (4) In the 17th line of the second page of the specification, "We are using a method." is corrected to "There is a method." (5) "Syringe" in line 19 of page 4 and line 15 of page 6 of the specification is corrected to "syringe barrel." (6) On page 6, line 18 of the specification, after "at this time,""by repeated operation of raising the forceps of the endoscope, etc."
join. (7) Delete "at this time" in the 10th line of page 7 of the specification. (8) Correct box 3 in the drawing as shown in the attached sheet.

Claims (2)

[Claims] (1) A knife wire having an incision for cauterization exposed on the outer surface near the tip of the insulating flexible tube and through which a high-frequency current for cauterization is applied, and an incision provided inside the flexible tube. A high-frequency cutting instrument having a reinforcing wire for reinforcing a flexible tube near the tip of the reinforcing wire, an opening near the tip of the flexible tube, a suction section on the proximal side, and an operation section for the knife wire. A high-frequency cutting tool characterized by being equipped with a stopper. (2) The stopper has an elastic end portion that bites into the inner surface of the flexible tube.
High-frequency cutting instrument as described in Section 1.