CN116710015A - Treatment tool - Google Patents

Abstract

The treatment instrument includes: a sheath having flexibility; a rod provided at a distal end of the sheath so as to be capable of protruding and sinking, the rod having a first electrode to which a high-frequency current is applied at the distal end; a second electrode provided at the distal end of the sheath so as to be deformable, the second electrode having conductivity; and an operation unit provided at a base end of the sheath, for advancing and retreating the rod, wherein the second electrode is energized by being in contact with the first electrode of the rod, and the second electrode is deformed by being in contact with the first electrode of the rod.

Description

Treatment tool

Technical Field

The present invention relates to a treatment tool.

Background

Conventionally, in endoscopic treatment such as ESD (endoscopic submucosal dissection), an endoscopic treatment tool for dissection, such as a high-frequency knife, has been used. When bleeding occurs during an operation, it is necessary to temporarily take out an endoscopic treatment tool for incision and dissection from the body cavity, and replace the endoscopic treatment tool for hemostasis with the endoscopic treatment tool for hemostasis to perform an endoscopic hemostasis operation.

Patent document 1 describes a high-frequency treatment tool for an endoscope, which can perform incision and dissection treatments and hemostatic treatments of tissues. The high-frequency treatment tool for an endoscope described in patent document 1 can perform incision, peeling treatment, and hemostatic treatment without changing the treatment tool.

Prior art literature

Patent literature

Patent document 1: japanese patent laid-open publication No. 2013-111308

Disclosure of Invention

Problems to be solved by the invention

However, in the high-frequency treatment tool for an endoscope described in patent document 1, the shape of the distal end portion to which high-frequency current is applied cannot be adjusted in the treatment of cauterizing the bleeding portion to stop bleeding, and it is difficult to perform the hemostasis treatment according to the size of the bleeding portion.

In view of the above, an object of the present invention is to provide a treatment tool capable of performing incision, peeling treatment, and hemostatic treatment, which can perform appropriate hemostatic treatment according to the size of a bleeding site.

Solution for solving the problem

In order to solve the above problems, the present invention proposes the following.

A treatment device according to a first aspect of the present invention includes: a sheath having flexibility; a rod provided at a distal end of the sheath so as to be capable of protruding and sinking, the rod having a first electrode to which a high-frequency current is applied at the distal end; a second electrode provided at the distal end of the sheath so as to be deformable, the second electrode having conductivity; and an operation unit provided at a base end of the sheath, for advancing and retreating the rod, wherein the second electrode is energized by being in contact with the first electrode of the rod, and the second electrode is deformed by being in contact with the first electrode of the rod.

ADVANTAGEOUS EFFECTS OF INVENTION

The treatment tool of the present invention can be used for performing incision, peeling treatment and hemostasis treatment, and can also be used for performing appropriate hemostasis treatment according to the size of a bleeding site.

Drawings

Fig. 1 is an overall view of an endoscope treatment system according to a first embodiment.

Fig. 2 is an overall view showing a treatment tool of the endoscope treatment system according to the first embodiment.

Fig. 3 is a perspective view of the distal end portion of the treatment tool according to the first embodiment.

Fig. 4 is a front view of the distal end portion of the treatment tool according to the first embodiment and a cross-sectional view taken along the longitudinal direction.

Fig. 5 is a front view and a longitudinal cross-sectional view of the distal end portion of the treatment tool according to the first embodiment in a state where the second electrode is deformed.

Fig. 6 is a front view and a longitudinal sectional view of the distal end portion of the treatment tool according to the first embodiment in a state in which the second electrode is further deformed.

Fig. 7 is a front view and a longitudinal sectional view of the distal end portion of the treatment tool according to the first embodiment in a state where the second electrode is deformed to the maximum extent.

Fig. 8 is a plan view of an operation unit of the treatment instrument according to the first embodiment.

Fig. 9 is a cross-sectional view of the operation section of the first embodiment taken along the line X-X in fig. 8.

Fig. 10 is a sectional view of the operation section of the first embodiment taken along the line Y-Y in fig. 9.

Fig. 11 is a sectional view of the operation section of the first embodiment taken along the line Y-Y in fig. 9.

Fig. 12 is a view showing a treatment tool according to the first embodiment in which a slider of an operation unit according to the first embodiment is fixed to a distal end side.

Fig. 13 is a view showing a treatment tool according to the first embodiment in which a slider of an operation unit according to the first embodiment is fixed to a base end side.

Fig. 14 is a perspective view of a distal end portion of a treatment tool according to a second embodiment of the present invention.

Fig. 15 is a longitudinal cross-sectional view of the distal end portion of the treatment tool according to the second embodiment.

Fig. 16 is a longitudinal cross-sectional view of a modification of the second electrode of the treatment instrument according to the second embodiment.

Fig. 17 is a longitudinal cross-sectional view of the distal end portion of the treatment tool according to the third embodiment of the present invention.

Fig. 18 is a longitudinal cross-sectional view of the distal end portion of the treatment tool according to the fourth embodiment of the present invention.

Fig. 19 is a longitudinal cross-sectional view of the treatment tool according to the fourth embodiment in a state in which the second electrode is deformed.

Fig. 20 is a front view of the distal end portion of the treatment tool according to the fifth embodiment of the present invention and a cross-sectional view taken along the longitudinal direction.

Fig. 21 is a longitudinal cross-sectional view of the distal end portion of the treatment tool according to the fifth embodiment in a state where the second electrode starts to deform.

Fig. 22 is a longitudinal cross-sectional view of the distal end portion of the treatment tool according to the fifth embodiment in a state in which the second electrode is further deformed.

Fig. 23 is a perspective view of a second locking mechanism of an operation unit of a treatment instrument according to a sixth embodiment of the present invention.

Fig. 24 is a view showing an operation portion of the sixth embodiment in which the position of the slider is fixed to the tip side by the second lock mechanism of the sixth embodiment.

Fig. 25 is a view showing an operation portion of the sixth embodiment in which the position of the slider is fixed to the base end side by the second lock mechanism of the sixth embodiment.

Detailed Description

(first embodiment)

An endoscope treatment system 300 according to a first embodiment of the present invention will be described with reference to fig. 1 to 13. Fig. 1 is an overall view of an endoscope treatment system 300 according to the present embodiment.

[ endoscope treatment System 300]

As shown in fig. 1, the endoscope treatment system 300 includes an endoscope 200 and a treatment tool 100. The treatment tool 100 is inserted into the endoscope 200 and used.

[ endoscope 200]

The endoscope 200 is a known flexible endoscope, and includes an insertion portion 202 inserted from the distal end into the body and an operation portion 207 attached to the proximal end of the insertion portion 202.

The insertion portion 202 includes an imaging portion 203, a bending portion 204, and a soft portion 205. An imaging unit 203, a bending unit 204, and a soft unit 205 are disposed in this order from the distal end of the insertion unit 202. A passage 206 through which the treatment tool 100 is inserted is provided inside the insertion portion 202. A distal end opening 206a of the passage 206 is provided at the distal end of the insertion portion 202.

The imaging unit 203 includes an imaging element such as a CCD or CMOS, for example, and can capture a region to be treated. The imaging unit 203 can capture the electrode unit 3 of the treatment instrument 100 in a state where the treatment instrument 100 protrudes from the distal end opening 206a of the channel 206.

The bending portion 204 is bent in response to an operation performed by the operator on the operation portion 207. The soft portion 205 is a flexible tubular portion.

The operation portion 207 is connected to the flexible portion 205. The operation section 207 has a grip 208, an input section 209, a base end opening section 206b of the channel 206, and a universal cable 210. The handle 208 is a portion to be gripped by an operator. The input unit 209 receives an operation input for causing the bending unit 204 to perform a bending operation. The universal cable 210 outputs the image captured by the imaging unit 203 to the outside. The universal cable 210 is connected to a display device such as a liquid crystal display via an image processing device including a processor or the like.

[ treatment tool 100]

Fig. 2 is an overall view showing the treatment tool 100.

The treatment tool 100 is a treatment tool capable of performing incision, peeling treatment, and hemostatic treatment. The treatment tool 100 includes a sheath 1, a rod 2, an electrode portion 3, an operation wire 4 (shown in fig. 4), and an operation portion 5. In the following description, the side of the treatment instrument 100 in the longitudinal direction a that is inserted into the body of the patient is referred to as "distal end side (A1)", and the operation unit 5 side is referred to as "proximal end side (A2)".

The sheath 1 is made of an electrically insulating material such as tetrafluoroethylene, and is a long member having flexibility and extending from the distal end 1a to the proximal end 1 b. The sheath 1 has an outer diameter that can be inserted into the channel 206 of the endoscope 200. As shown in fig. 1, in a state where the sheath 1 is inserted into the passage 206, the front end 1a of the sheath 1 can be projected and submerged into the front end opening 206a of the passage 206.

Fig. 3 is a perspective view of the distal end portion of the treatment tool 100.

The rod 2 is a substantially round rod-shaped member having a metal material such as stainless steel, and is provided at the distal end 1a of the sheath 1 so as to be capable of protruding and sinking. The rod 2 has a rod body 20, a first electrode 21, and a stopper 22.

Fig. 4 is a front view of the distal end portion of the treatment tool 100 and a cross-sectional view along the longitudinal direction a.

The rod 2 penetrates the electrode portion 3 along the longitudinal direction a so as to be movable in a forward and backward direction. The central axis O2 in the longitudinal direction a of the rod 2 substantially coincides with the central axis O1 in the longitudinal direction a of the sheath 1.

The rod body 20 is a round rod-shaped member having a metal material such as stainless steel. An insulating coating 20a is applied to the front end portion of the lever main body 20. The operation wire 4 is mounted to the base end of the lever main body 20 via a stopper 22. The lever body 20 supplies the high-frequency current supplied from the operation wire 4 connected to the operation unit 5 to the first electrode 21.

The first electrode 21 is a disk-shaped conductive member provided at the front end of the lever body 20. The outer periphery of the first electrode 21 and the outer periphery of the rod main body 20 are formed in concentric circles when viewed from the front view in the direction horizontal to the longitudinal direction a. The length L1 of the first electrode 21 in the radial direction R perpendicular to the longitudinal direction a is longer than the length L2 of the rod body 20 in the radial direction R. The portion of the first electrode 21 and the rod body 20 exposed from the distal end of the second electrode 32 functions as a high-frequency electrode for applying a high-frequency current to the living tissue, and mainly performs incision and dissection treatments. However, depending on the situation, hemostatic treatments may also be performed.

The first electrode 21 has a first hemostatic treatment surface S1 perpendicular to the longitudinal direction a on the distal end side A1. The first hemostatic treatment surface S1 is used for hemostatic treatment in a state where the first electrode 21 and the second electrode 32 are in contact. The first hemostatic treatment surface S1 may be formed as a flat surface or a curved surface.

The stopper 22 is provided on the outer periphery of the lever body 20 and the operation wire 4, and connects the lever body 20 and the operation wire 4. Further, the stopper 22 limits the length of the rod body 20 exposed from the front end of the second electrode 32. As a result, the protruding amount of the first electrode 21 is also limited. As shown in fig. 4, the stopper 22 engages with the electrode portion 3 provided at the distal end 1a of the sheath 1 to limit the protruding amount of the first electrode 21.

The electrode portion 3 is provided at the front end 1a of the sheath 1. The electrode portion 3 has a support member 31 and a second electrode 32.

The support member 31 is formed of a metal material such as stainless steel or an insulating material such as ceramic. The support member 31 is fixed to the distal end 1a of the sheath 1, and supports the second electrode 32. The support member 31 is fixed to the front end 1a of the sheath 1 by welding, an adhesive, or the like. The support member 31 has a through hole 31a through which the rod 2 passes. The support member 31 is formed of a material harder than the second electrode 32, so that the second electrode is easily deformed in the radial direction by the retraction of the first electrode without moving into the sheath 1.

The second electrode 32 is a hollow member having conductivity and elasticity, and is formed of, for example, conductive silicone rubber. The second electrode 32 is fixed to the front end side of the support member 31 by welding, an adhesive, or the like. The second electrode 32 has a through hole 32b through which the rod 2 passes.

As shown in fig. 4, the second electrode 32 is formed in a hemispherical shape in a state where no external force is applied. Specifically, the second electrode 32 is formed in a hemispherical shape having a convex tip side A1 in a state where no external force is applied. In the present embodiment, the protruding tip 32a protruding toward the tip side A1 is located near the central axis O3 in the longitudinal direction a of the second electrode 32.

The through hole 32b is opened at a convex tip portion 32a protruding toward the distal end side A1. The second electrode 32 protrudes toward the front end side A1 as approaching the through hole 32b. The through hole 32b is formed along the central axis O3 in the longitudinal direction a of the second electrode 32.

The length L3 of the through hole 32b in the radial direction R is longer than the length L2 of the rod main body 20 in the radial direction R. Therefore, the rod body 20 can move forward and backward in the longitudinal direction a in the through hole 32b. In the following description, the movement of the rod 2 toward the distal end side A1 is referred to as "forward", and the movement of the rod 2 toward the proximal end side A2 is referred to as "backward".

Fig. 5 is a front view of the distal end portion of the treatment tool 100 in a state where the second electrode 32 is deformed, and a cross-sectional view along the longitudinal direction a. The length L1 of the first electrode 21 in the radial direction R is longer than the length L3 of the through hole 32b in the radial direction R. Therefore, when the second electrode 32 retreats, the second electrode 32 contacts the tip end portion 32a of the second electrode 32. The second electrode 32 is deformed in contact with the first electrode 21. When the first electrode 21 advances and separates from the second electrode 32, the second electrode 32 returns to its original shape. In the following description, the original shape of the second electrode 32 is also referred to as "initial shape" of the second electrode 32.

The insulating coating 20a is applied to the distal end portion of the rod main body 20, and even if the distal end portion of the rod main body 20 to which the high-frequency current is applied contacts the second electrode 32, no current is applied from the rod main body 20 to the second electrode 32. On the other hand, when the first electrode 21 to which the high-frequency current is applied contacts the second electrode 32, the high-frequency current is applied from the first electrode 21 to the second electrode 32. In this state, the second electrode 32 functions as a high-frequency electrode for applying a high-frequency current to the living tissue, and mainly performs hemostatic treatment.

As shown in fig. 5, the second electrode 32 is deformed by being pressed by the first electrode 21 that is retreated. Specifically, the curvature of the surface of the deformed front end portion 32a of the second electrode 32 becomes smaller than that of the original shape. As a result, the second hemostatic treatment surface S2 having a smaller curvature is formed on the distal end side A1.

The first hemostatic treatment surface S1 and the second hemostatic treatment surface S2 form a hemostatic treatment surface S that facilitates hemostatic treatment of a bleeding site disposed on the front side in the longitudinal direction a. The hemostatic treatment surface S preferably forms a generally coplanar plane or curved surface.

Fig. 6 is a front view of the distal end portion of the treatment tool 100 in a state in which the second electrode 32 is further deformed, and a cross-sectional view along the longitudinal direction a. The second hemostatic treatment surface S2 becomes larger as the contacted first electrode 21 recedes.

Fig. 7 is a front view of the distal end portion of the treatment tool 100 in a state where the second electrode 32 is deformed to the maximum extent, and a cross-sectional view along the longitudinal direction a. The second electrode 32 is deformed to be larger than the sheath 1 in the radial direction R in a main view seen from a direction horizontal to the longitudinal direction a. The second hemostatic treatment surface S2 has the smallest curvature and the largest area when the contacted first electrode 21 is retreated to the maximum extent.

The operation wire 4 is a wire made of a metal material such as stainless steel, and penetrates the inner space 10 of the sheath 1. The tip of the operation wire 4 is connected to the lever 2, and the base end of the operation wire 4 is connected to the operation unit 5.

Fig. 8 is a plan view of the operation unit 5.

The operation unit 5 includes an operation unit main body 51, a slider 52, a power supply connector 53, and a lock mechanism 54.

The distal end portion of the operating portion main body 51 is connected to the base end 1b of the sheath 1. The operation unit main body 51 has an internal space S through which the operation wire 4 can pass. The operation wire 4 extends to the slider 52 through the inner space 10 of the sheath 1 and the inner space 50 of the operation part main body 51.

The slider 52 is attached to the operation unit body 51 so as to be movable in the longitudinal direction a with respect to the operation unit body 51. The slider 52 is connected to a base end portion of the operation wire 4. The operator advances and retreats the slider 52 relative to the operation unit main body 51, thereby advancing and retreating the operation wire 4 and the rod 2 relative to the sheath 1. A power supply connector 53 is fixed to the slider 52.

The power supply connector 53 is connectable to a high-frequency power supply device, not shown, and is electrically and physically connected to the base end portion of the operation wire 4. The power supply connector 53 can supply the high-frequency current supplied from the high-frequency power supply device to the first electrode 21 via the operation wire 4 and the lever main body 20.

Fig. 9 is a sectional view of the operation section 5 taken along the line X-X in fig. 8.

The lock mechanism 54 fixes the position of the slider 52 in the longitudinal direction a, thereby fixing the projecting/sinking position of the lever 2. The lock mechanism 54 has an engaged groove 55 and a movable engagement portion 56.

As shown in fig. 8 and 9, the engaged groove portion 55 has a plurality of grooves 55a formed in the operation portion main body 51. The groove 55a is a groove having a width direction B perpendicular to the longitudinal direction a as a depth direction, and is opened in the inner space 50 side of the operation unit main body 51. The plurality of grooves 55a are arranged in the longitudinal direction a.

As shown in fig. 9, the movable engagement portion 56 is attached to the slider 52. The movable engagement portion 56 has elasticity and is movable between a first position P1, which is an initial position, and a deformed second position P2. The movable engagement portion 56 is formed in an L-shape when viewed from the front view in the width direction B perpendicular to the longitudinal direction a, and has a pressing portion 56a protruding with respect to the slider 52.

Fig. 10 is a sectional view of the operation section 5 taken along the line Y-Y in fig. 9.

The movable engagement portion 56 shown in fig. 10 is in a state where no external force is applied, and is disposed at a first position P1 as an initial position. The movable engagement portion 56 has a protruding portion 56B protruding in the width direction B. When the movable engagement portion 56 is at the first position P1, the protruding portion 56b engages with any one of the plurality of grooves 55a. As a result, the position of the slider 52 in the longitudinal direction a is fixed.

Fig. 11 is a sectional view of the operation section 5 taken along the Y-Y line in fig. 9.

The movable engagement portion 56 shown in fig. 11 is pushed by the operator in the direction in which the pressing portion 56a approaches the slider 52, and is disposed at the second position P2. When the movable engagement portion 56 is at the second position P2, the protruding portion 56b does not engage with any of the plurality of grooves 55a. As a result, the position of the slider 52 in the longitudinal direction a is not fixed.

The operator pushes the pressing portion 56a in a direction toward the slider 52, and moves the movable engagement portion 56 to the second position P2. After releasing the engagement between the groove 55a and the projection 56b (releasing the locking mechanism 54), the operator changes the position of the slider 52 in the longitudinal direction a.

After changing the position of the slider 52 in the longitudinal direction a, the operator releases the force applied to the pressing portion 56a, and returns the movable engagement portion 56 to the first position P1. The groove 55a and the projection 56b are engaged, and the position of the slider 52 in the longitudinal direction a is fixed again.

Fig. 12 is a view showing a treatment tool 100 in which the slider 52 is fixed to the distal end side.

In a state where the first electrode 21 protrudes with respect to the second electrode 32, the protruding and sinking position of the rod 2 is fixed. The operator can easily perform incision and peeling treatment using the first electrode 21 fixed in a protruding state.

Fig. 13 is a view showing a treatment tool 100 in which the slider 52 is fixed to the base end side.

In a state where the first electrode 21 is in contact with the second electrode 32, the protruding submerged position of the rod 2 is fixed. The operator can easily perform hemostatic treatment using the hemostatic treatment surface S formed by the first electrode 21 and the second electrode 32. Since the protruding and sinking position of the rod 2 is fixed, the size of the hemostatic treatment surface S is maintained.

[ method of Using the endoscope treatment System 300]

Next, an operation (a method of using the endoscope treatment system 300) performed by using the endoscope treatment system 300 of the present embodiment will be described. Specifically, a procedure of incising, dissecting, and hemostatic a lesion in endoscopic treatment such as ESD (endoscopic submucosal dissection) will be described.

As a preparation work, the operator identifies a lesion by a known method and swells the lesion. Specifically, the operator inserts the insertion portion 202 of the endoscope 200 into a digestive tract (for example, esophagus, stomach, duodenum, and large intestine), and identifies a lesion while observing an image obtained by the imaging portion 203 of the endoscope. Next, the operator inserts a known submucosal local injection needle into the channel 206 of the insertion portion 202, and injects a liquid for local injection (local injection liquid) with the submucosal local injection needle to bulge the lesion. The submucosal local injection needle is withdrawn from the channel 206 after the local injection is injected.

The operator inserts the treatment tool 100 into the channel 206, and projects the distal end 1a of the sheath 1 from the distal end opening 206a of the insertion portion 202. The operator advances the slider 52 of the operation unit 5 relative to the operation unit main body 51, and protrudes the lever 2.

The operator advances the rod 2, and moves the first electrode 21 in a state where a high-frequency current is applied thereto, thereby incising the mucous membrane of the lesion. The operator advances the rod 2, lifts up the mucous membrane of the incised lesion to expose the submucosa, and peels off the submucosa of the incised lesion in a state where a high-frequency current is applied.

In the incision and peeling treatment, bleeding is often accompanied. In the case of bleeding, the operator performs a hemostatic treatment. The hemostasis treatment is a treatment of cauterizing the ulcer part after the lesion part is peeled off, and the bleeding part bleeding during the incision and peeling treatment to stop bleeding.

The operator withdraws the rod 2, bringing the first electrode 21 into contact with the second electrode 32. The operator adjusts the size of the hemostatic treatment surface S according to the hemostatic object. When the hemostatic object is large, the rod 2 is retracted to the second hemostatic treatment surface S2 to be maximum as shown in fig. 7. The size of the hemostatic treatment surface S formed by the first hemostatic treatment surface S1 and the second hemostatic treatment surface S2 is adjusted in multiple stages according to the hemostatic object.

The second electrode 32 is deformed to be larger than the sheath 1 in the radial direction R in a main view seen from a direction horizontal to the longitudinal direction a. Therefore, even when the hemostatic object is large, the operator can increase the hemostatic treatment surface S and appropriately perform the hemostatic treatment.

The operator presses the hemostatic treatment surface S against the bleeding ulcer and the hemostatic target of the mucous membrane, and applies a high-frequency current to the rod 2 to burn the hemostatic treatment surface. Since the projecting and sinking position of the lever 2 is fixed by the locking mechanism 54 of the operation unit 5, the operator can perform the hemostatic treatment while maintaining the size of the hemostatic treatment surface S. Therefore, the situation that the hemostatic part is not required to be cauterized can be appropriately prevented.

The operator continues the above operation (treatment) as needed, and finally resects the lesion, ending the ESD operation.

With the treatment instrument 100 of the present embodiment, incision, peeling, and hemostatic treatments can be performed, and appropriate hemostatic treatments according to the size of the bleeding site can be performed. The operator can easily perform hemostatic treatment without using a treatment tool dedicated to hemostatic treatment. The operator can reliably cauterize the hemostatic object by using the hemostatic treatment surface S adjusted in multiple stages according to the hemostatic object.

The first embodiment of the present invention has been described in detail with reference to the drawings, but the specific configuration is not limited to this embodiment, and design changes and the like without departing from the scope of the gist of the present invention are also included. The constituent elements shown in the above embodiments and modifications can be appropriately combined.

Modification 1-1

In the above embodiment, the endoscope 200 is a flexible endoscope. The treatment tool 100 may be used as an endoscope treatment system together with a rigid endoscope.

Modification 1-2

In the above embodiment, the insulating coating 20a is applied to the distal end portion of the rod main body 20, and no current is supplied from the rod 2 to the second electrode 32 in a state where the first electrode 21 is not in contact with the second electrode 32. However, the insulating state of the rod main body 20 and the second electrode 32 is not limited thereto. The insulating coating 20a may not be applied to the rod body 20, but may be applied to the inner peripheral surface of the through hole 32b of the second electrode 32.

Modification 1-3

In the above embodiment, the rod 2 penetrates the second electrode 32. However, the aspects of the rod 2 and the second electrode 32 are not limited thereto. If the retreated rod 2 is configured to deform the second electrode 32, the rod 2 may not penetrate the second electrode 32.

(second embodiment)

A treatment tool 100B according to a second embodiment of the present invention will be described with reference to fig. 14 to 15. In the following description, the same reference numerals are given to the structures common to those already described, and the duplicate description is omitted.

[ treatment tool 100B ]

The treatment instrument 100B is used as an endoscope treatment system together with the endoscope 200, similarly to the treatment instrument 100 of the first embodiment. The treatment tool 100B is a treatment tool capable of performing incision, peeling treatment, and hemostatic treatment. The treatment tool 100B includes a sheath 1, a rod 2, an electrode portion 3B, an operation wire 4, and an operation portion 5.

Fig. 14 is a perspective view of the distal end portion of the treatment tool 100B.

The electrode portion 3B is provided at the front end 1a of the sheath 1. The electrode portion 3B has a support member 31 and a second electrode 32B.

Fig. 15 is a cross-sectional view of the distal end portion of the treatment tool 100B along the longitudinal direction a.

The second electrode 32B is a solid member having conductivity and elasticity. The second electrode 32B is fixed to the front end side of the support member 31 by welding, an adhesive, or the like. The second electrode 32B has a slit 33B and a through hole 32B through which the rod 2 passes.

As shown in fig. 15, the second electrode 32B is formed in a hemispherical shape in a state where no external force is applied. Specifically, the second electrode 32B is formed in a hemispherical shape having a convex tip side A1 in a state where no external force is applied. In the present embodiment, the convex tip portion 32a protruding toward the tip side A1 is located near the central axis O3 in the longitudinal direction a of the second electrode 32B.

As shown in fig. 14, the slit 33B is a cutout provided in the second electrode 32B. The slit 33B is formed over the entire circumference in the circumferential direction C with the center axis O3 in the longitudinal direction a of the second electrode 32B as the rotation center.

As shown in fig. 15, the slit 33B is an isosceles triangle-shaped cutout having the tip end side A1 as a vertex angle in a cross section along the longitudinal direction a. The slit 33B opens at the base end side A2 of the second electrode 32B. An internal space 34B partitioned by the slit 33B is formed inside the second electrode 32B.

The second electrode 32B is deformed by being pressed by the retreated first electrode 21, similarly to the second electrode 32 of the first embodiment. The second electrode 32B is softer than the second electrode 32 of the first embodiment in that the internal space 34B formed by the slit 33B is formed on the base end side A2, and the portion of the second electrode 32B on the base end side A2 is softer. Therefore, the second electrode 32B is easier to deform on the base end side than the second electrode 32 of the first embodiment. Further, the second electrode 32B tends to be wider in the radial direction R when pressed from the front end side. Since the second electrode 32B is liable to vary in the radial direction R, the operator can more easily adjust the size of the hemostatic treatment surface S.

With the treatment tool 100B of the present embodiment, incision, peeling, and hemostasis treatments can be performed, and appropriate hemostasis treatments according to the size of the bleeding site can be performed. The operator can easily perform hemostatic treatment without using a treatment tool dedicated to hemostatic treatment. The operator can reliably cauterize the hemostatic object by using the hemostatic treatment surface S adjusted in multiple stages according to the hemostatic object.

The second embodiment of the present invention has been described in detail with reference to the drawings, but the specific configuration is not limited to this embodiment, and design changes and the like without departing from the scope of the gist of the present invention are also included. The constituent elements shown in the above embodiments and modifications can be appropriately combined.

Modification 2-1

In the above embodiment, the slit 33B is an isosceles triangle shaped cutout having the tip end side A1 as a vertex angle in a cross section along the longitudinal direction a. However, the form of the second electrode 32B having the slit 33B is not limited thereto. The treatment instrument 100C shown in fig. 16 is a cross-sectional view along the longitudinal direction a of the second electrode 32C as a modification of the second electrode 32B. The second electrode 32C has a slit 33C instead of the slit 33B.

The slit 33C is a cutout provided in the second electrode 32C. The slit 33C is formed over the entire circumference of the circumferential direction C with the center axis O3 of the second electrode 32C in the longitudinal direction a as the rotation center.

The slit 33C is a rectangular cutout in a cross section along the longitudinal direction a. The slit 33C opens at the base end side A2 of the second electrode 32C. An internal space 34C partitioned by the slit 33C is formed inside the second electrode 32C. Slit 33C is easier to machine than slit 33B.

(third embodiment)

A treatment tool 100D according to a third embodiment of the present invention will be described with reference to fig. 17. In the following description, the same reference numerals are given to the structures common to those already described, and the duplicate description is omitted.

[ treatment tool 100D ]

The treatment instrument 100D is used as an endoscope treatment system together with the endoscope 200, similarly to the treatment instrument 100 of the first embodiment. The treatment tool 100D is a treatment tool capable of performing incision, peeling treatment, and hemostatic treatment. The treatment tool 100D includes a sheath 1, a rod 2, an electrode portion 3D, an operation wire 4, and an operation portion 5.

Fig. 17 is a cross-sectional view of the distal end portion of the treatment tool 100D along the longitudinal direction a.

The electrode portion 3D is provided at the distal end 1a of the sheath 1. The electrode portion 3D has a support member 31 and a second electrode 32D.

The second electrode 32D is a hollow member having conductivity and elasticity. An internal space 34D is formed inside the second electrode 32D. The second electrode 32D is fixed to the front end side of the support member 31 by welding, an adhesive, or the like. The second electrode 32D has a through hole 32b through which the rod 2 passes.

The internal space 34D is formed in a cylindrical shape with the central axis O3 in the longitudinal direction a of the second electrode 32C as the central axis. The length L4 of the inner space 34D in the radial direction R is longer than the length L1 of the first electrode 21 in the radial direction R.

The through hole 32b is formed at the front end side A1 of the inner space 34D. As shown in fig. 17, the lever body 20 penetrates the inner space 34D and the through hole 32b.

The second electrode 32D is deformed by being pressed by the retreated first electrode 21, similarly to the second electrode 32 of the first embodiment. The second electrode 32D is softer because the second electrode 32D is a hollow member and an internal space 34D is formed, as compared with the second electrode 32 of the first embodiment. Therefore, the second electrode 32D is easier to retract the rod 2 than the second electrode 32 of the first embodiment. Therefore, the operator can easily adjust the size of the hemostatic treatment surface S.

With the treatment tool 100D of the present embodiment, incision, peeling, and hemostasis treatments can be performed, and appropriate hemostasis treatments according to the size of the bleeding site can be performed. The operator can easily perform hemostatic treatment without using a treatment tool dedicated to hemostatic treatment. The operator can reliably cauterize the hemostatic object by using the hemostatic treatment surface S adjusted in multiple stages according to the hemostatic object.

The third embodiment of the present invention has been described in detail with reference to the drawings, but the specific configuration is not limited to this embodiment, and design changes and the like without departing from the scope of the gist of the present invention are also included. The constituent elements shown in the above embodiments and modifications can be appropriately combined.

Modification 3-1

In the above embodiment, the internal space 34D of the second electrode 32D as a hollow member is formed in a cylindrical shape. However, the shape of the internal space 34D is not limited thereto. The internal space 34D may also be, for example, hemispherical in shape similar to the hemispherical shape of the second electrode 32D.

(fourth embodiment)

A treatment tool 100E according to a fourth embodiment of the present invention will be described with reference to fig. 18 to 19. In the following description, the same reference numerals are given to the structures common to those already described, and the duplicate description is omitted.

[ treatment tool 100E ]

The treatment instrument 100E is used as an endoscope treatment system together with the endoscope 200, similarly to the treatment instrument 100 of the first embodiment. The treatment tool 100E is a treatment tool capable of performing incision, peeling treatment, and hemostatic treatment. The treatment tool 100E includes a sheath 1, a rod 2, an electrode portion 3E, an operation wire 4, and an operation portion 5.

Fig. 18 is a cross-sectional view of the distal end portion of the treatment tool 100E along the longitudinal direction a.

The electrode portion 3E is provided at the distal end 1a of the sheath 1. The electrode portion 3E includes a support member 31, a second electrode 32, and a reinforcing electrode 36.

The reinforcing electrode 36 is made of a conductive metal material such as stainless steel, and is harder than the second electrode 32. The reinforcing electrode 36 is provided at the tip of the second electrode 32 and on the inner peripheral surface of the through hole 32b of the second electrode 32. The second electrode 32 and the reinforcing electrode 36 are connected by welding, an adhesive, or the like.

Fig. 19 is a cross-sectional view along the longitudinal direction a of the treatment instrument 100E in a state in which the second electrode 32 is deformed by the retracted first electrode 21. The second electrode 32 is deformed by being pressed by the first electrode 21 which is retracted, similarly to the second electrode 32 of the first embodiment. Since the reinforcing electrode 36 is provided at the tip of the second electrode 32E, the second electrode 32 is deformed by being pressed by the reinforcing electrode 36 in contact with the retreated first electrode 21. A second hemostatic treatment surface S2 is formed on the distal end side A1 of the second electrode 32E.

Since the harder reinforcing electrode 36 is provided at the front end of the second electrode 32 and the inner peripheral surface of the through hole 32b of the second electrode 32, the force with which the first electrode 21 is pushed into the second electrode 32 becomes more uniform. Therefore, the deformed second electrode 32 is easily shaped symmetrically with respect to the central axis O3 when viewed from the longitudinal direction a, and the operator can easily adjust the size of the hemostatic treatment surface S.

When the first electrode 21 and the second electrode 32 to which the high-frequency current is applied are in contact with each other via the reinforcing electrode 36, the high-frequency current is applied from the first electrode 21 to the second electrode 32.

With the treatment instrument 100E of the present embodiment, incision, peeling, and hemostasis treatments can be performed, and appropriate hemostasis treatments according to the size of the bleeding site can be performed. The operator can easily perform hemostatic treatment without using a treatment tool dedicated to hemostatic treatment. The operator can reliably cauterize the hemostatic object by using the hemostatic treatment surface S adjusted in multiple stages according to the hemostatic object.

The fourth embodiment of the present invention has been described in detail with reference to the drawings, but the specific configuration is not limited to this embodiment, and design changes and the like without departing from the scope of the gist of the present invention are also included. The constituent elements shown in the above embodiments and modifications can be appropriately combined.

(fifth embodiment)

A treatment tool 100F according to a fifth embodiment of the present invention will be described with reference to fig. 20 to 22. In the following description, the same reference numerals are given to the structures common to those already described, and the duplicate description is omitted.

[ treatment tool 100F ]

The treatment tool 100F is used as an endoscope treatment system together with the endoscope 200, similarly to the treatment tool 100 of the first embodiment. The treatment tool 100F is a treatment tool capable of performing incision, peeling treatment, and hemostatic treatment. The treatment tool 100F includes a sheath 1, a rod 2, an electrode portion 3F, an operation wire 4, and an operation portion 5.

Fig. 20 is a front view of the distal end portion of the treatment tool 100F and a cross-sectional view taken along the longitudinal direction a.

The electrode portion 3F is provided at the distal end 1a of the sheath 1. The electrode portion 3F has a support member 31 and a second electrode 32F. The rod 2 penetrates the second electrode 32F along the central axis of the second electrode 32F.

The second electrode 32F is a conical coil spring (truncated cone spiral spring) formed of a metal material having conductivity, such as stainless steel. The second electrode 32F is formed in a cone shape having a smaller outer diameter from the base end side toward the tip end side. The second electrode 32F has a spiral shape in which the second electrodes 32F do not overlap each other when viewed from the front view in the longitudinal direction a. The second electrode 32F may be formed of a rubber having conductivity.

Fig. 21 is a cross-sectional view along the longitudinal direction a of the distal end portion of the treatment tool 100F in a state where the second electrode 32F starts to deform. The second electrode 32F is compressed by being pressed by the first electrode 21 that is retracted, similarly to the second electrode 32 of the first embodiment. A second hemostatic treatment surface S2 is formed on the distal end side A1 of the second electrode 32F.

Fig. 22 is a cross-sectional view along the longitudinal direction a of the distal end portion of the treatment tool 100F in a state where the second electrode 32F is further deformed. The second electrode 32F shown in fig. 22 is in a state of being compressed to the maximum extent in the longitudinal direction a. The second electrode 32F has a spiral shape in which the second electrodes 32F do not overlap each other when viewed from the front view in the longitudinal direction a. Therefore, when the second electrode 32F is in a state of being compressed to the maximum extent in the longitudinal direction a, the second hemostatic treatment surface S2 is formed to be substantially flat, and is suitable as a surface for performing hemostatic treatment.

When the first electrode 21 and the second electrode 32F to which the high-frequency current is applied are in contact, the high-frequency current is applied from the first electrode 21 to the second electrode 32F.

With the treatment tool 100F of the present embodiment, incision, peeling, and hemostasis treatments can be performed, and appropriate hemostasis treatments according to the size of the bleeding site can be performed. The operator can easily perform hemostatic treatment without using a treatment tool dedicated to hemostatic treatment. The operator can reliably cauterize the hemostatic object by using the hemostatic treatment surface S adjusted in multiple stages according to the hemostatic object.

The fifth embodiment of the present invention has been described in detail with reference to the drawings, but the specific configuration is not limited to this embodiment, and design changes and the like without departing from the scope of the gist of the present invention are also included. The constituent elements shown in the above embodiments and modifications can be appropriately combined.

(sixth embodiment)

A treatment tool 100G according to a sixth embodiment of the present invention will be described with reference to fig. 23 to 25. In the following description, the same reference numerals are given to the structures common to those already described, and the duplicate description is omitted.

[ treatment tool 100G ]

The treatment tool 100G is used as an endoscope treatment system together with the endoscope 200, similarly to the treatment tool 100 of the first embodiment. The treatment tool 100G is a treatment tool capable of performing incision, peeling treatment, and hemostatic treatment. The treatment tool 100G includes a sheath 1, a rod 2, an electrode portion 3, an operation wire 4, and an operation portion 5G.

The operation unit 5G includes an operation unit main body 51, a slider 52, a power supply connector 53, a lock mechanism 54, and a second lock mechanism 57.

Fig. 23 is a perspective view of the second locking mechanism 57 of the operation unit 5G.

The second lock mechanism 57 is a member that is detachable from the operating unit main body 51. The second lock mechanism 57 is formed in a U-shape. Barbs 57a are formed at both end portions of the second locking mechanism 57.

Fig. 24 is a diagram showing the operation portion 5G for fixing the position of the slider 52 to the tip end side A1 by the second lock mechanism 57. Fig. 25 is a view showing an operation portion 5G for fixing the position of the slider 52 to the base end side A2 by the second lock mechanism 57. When the second lock mechanism 57 is attached to the operating unit body 51, the barb portion 57a engages with the operating unit body 51 and is fixed to the operating unit body 51. Therefore, the second lock mechanism 57 is attached to the operation unit main body 51 to restrict the advancing and retreating movement of the slider 52.

By fixing the position of the slider 52 by the second locking mechanism 57, the projecting-sinking position of the rod 2 is more reliably fixed in a state where the first electrode 21 projects with respect to the second electrode 32. The operator can easily perform incision and peeling treatment using the first electrode 21 fixed in a protruding state.

With the treatment tool 100G of the present embodiment, incision, peeling, and hemostasis treatments can be performed, and appropriate hemostasis treatments according to the size of the bleeding site can be performed. The operator can easily perform hemostatic treatment without using a treatment tool dedicated to hemostatic treatment. The operator can reliably cauterize the hemostatic object by using the hemostatic treatment surface S adjusted in multiple stages according to the hemostatic object.

The sixth embodiment of the present invention has been described in detail with reference to the drawings, but the specific configuration is not limited to this embodiment, and design changes and the like without departing from the scope of the gist of the present invention are also included. The constituent elements shown in the above embodiments and modifications can be appropriately combined.

Industrial applicability

The present invention can be applied to a treatment tool used for hemostatic treatment.

Description of the reference numerals

300. An endoscope disposal system; 200. an endoscope; 100. 100B, 100C, 100D, 100E, 100F, 100G, and treatment implement; 1. a sheath; 2. a rod; 20. a lever body; 20a, an insulating coating; 21. a first electrode; 22. a stopper; 3. 3B, 3D, 3E, 3F, electrode portions; 31. a support member; 31b, through holes; 32. 32B, 32C, 32D, 32F, a second electrode; 32a, a front end portion; 32b, through holes; 33B, 33C, slits; 34B, 34C, 34D, an inner space; 36. reinforcing the electrode; 4. an operation wire; 5. 5G, an operation part; 51. an operation unit main body; 52. a slider; 54. a locking mechanism; 57. a second locking mechanism.

Claims (12)

1. A treatment instrument, wherein,

the treatment tool includes:

a sheath having flexibility;

a rod provided at a distal end of the sheath so as to be capable of protruding and sinking, the rod having a first electrode to which a high-frequency current is applied at the distal end;

a second electrode provided at the distal end of the sheath so as to be deformable, the second electrode having conductivity; and

an operation part provided at a base end of the sheath for advancing and retreating the rod,

the second electrode is energized by contact with the first electrode of the rod,

the second electrode is deformed by contact with the first electrode of the rod.

2. The treatment instrument of claim 1, wherein,

the second electrode has a through hole through which the rod passes.

3. The treatment instrument of claim 1, wherein,

the second electrode is an elastic member.

4. The treatment instrument of claim 1, wherein,

the second electrode is formed in a hemispherical shape.

5. The treatment instrument of claim 1, wherein,

the first electrode forms a first hemostatic treatment surface contacting with a hemostatic treatment object on the front end side,

the second electrode forms a second hemostatic treatment surface that is substantially planar with the first hemostatic treatment surface,

the second hemostatic treatment surface increases as the contacted first electrode recedes.

6. The treatment instrument of claim 1, wherein,

the operating portion has a locking mechanism that fixes the projecting and sinking position of the lever.

7. The treatment instrument of claim 1, wherein,

the second electrode has a slit from a base end toward a front end.

8. The treatment instrument of claim 1, wherein,

the treatment tool has a conductive reinforcing electrode provided at the distal end of the second electrode, and is formed of a material harder than the second electrode.

9. The treatment instrument of claim 1, wherein,

an insulating coating is provided around at least a portion of the shaft.

10. The treatment instrument of claim 1, wherein,

a support member is provided between the front end of the sheath and the base end of the second electrode, the support member being formed of a harder material than the second electrode.

11. The treatment instrument of claim 1, wherein,

in a state where the second electrode is not deformed, the second electrode is disposed in a projection plane of the sheath.

12. The treatment instrument of claim 1, wherein,

in a state where the second electrode is deformed, a part of the second electrode is disposed outside the projection of the sheath.