CN207666692U - Endoscope-use high-frequency treatment instrument - Google Patents
Endoscope-use high-frequency treatment instrument Download PDFInfo
- Publication number
- CN207666692U CN207666692U CN201790000013.6U CN201790000013U CN207666692U CN 207666692 U CN207666692 U CN 207666692U CN 201790000013 U CN201790000013 U CN 201790000013U CN 207666692 U CN207666692 U CN 207666692U
- Authority
- CN
- China
- Prior art keywords
- knife
- face
- endoscope
- protrusion member
- high frequency
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Active
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Otolaryngology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Plasma & Fusion (AREA)
- Physics & Mathematics (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
The utility model provides a kind of endoscope-use high-frequency treatment instrument, has flexible sheath.Conductive retainer is embedded in the front end of sheath.Conductive line is inserted in the inside of sheath.Online front end connects conductive rodlike high frequency knife.When making line advance or retreat in sheath by operation portion, the front end face length outstanding of knife from sheath generates variation.It is connected with high frequency electric source in contact portion, so that high-frequency current is flowed into knife and retainer via line.In the position for retreating specified amount from the front end face of knife, it is equipped with from the side of knife protrusion member outstanding.When making line retreat, protrusion member is connected to retainer.At this point, the front end face of knife protrudes specified amount from the front end face of retainer.The front end side of protrusion member is tapering shape.Therefore, the near border in the side of high frequency knife and the conical by its shape face of protrusion member contacts mucous membrane, can cut mucous membrane.
Description
Technical field
The utility model is related to a kind of endoscope-use high-frequency treatment instrument, the processing utensil for being inserted into endoscope inserts channel
And it uses.
Background technology
As being capable of using endoscope and reliably disposably excision early esophageal cancer, early carcinoma of stomach, Early cancer etc.
Involve the method for large-scale lesion, it is known that submucosa decollement (the Endoscopic Submucosal of endoscope
Dissection, Endoscopic submucosal dissection (hereinafter referred to as " ESD ").ESD operations are constituted by handling (process) as follows：(1) right
In (label) is marked in the excision extension of lesion, (2) make non-cancer lesion portion swell to submucosa local injection liquid
(local injection), (3) cut around non-cancer lesion portion according to label after to submucosa removed (incision/stripping),
(4) stopped blooding (hemostasis) to the bleeding generated when the ulcer surface of stripping or incision, stripping.In each process of ESD, use
Dedicated disposable endoscope processing utensil.Such as Japanese Unexamined Patent Publication 2010-42155 bulletins are (hereinafter, be denoted as " patent document
1 ") recorded, in the process of incision/stripping, use the endoscope treatment tool for having needle knife etc..The needle knife passes through logical
Enter high-frequency current to cut off mucous membrane etc..
Since ESD is the therapy for disposably cutting off large-scale lesion, treatment time is long, the difficulty of operation
Degree is also high.Therefore, when carrying out the excision of mucous membrane etc., in most cases with bleeding.When generating bleeding in the course of surgery,
Operator needs temporarily to take out the endoscope treatment tool of incision/stripping out of body cavity, and is changed to the interior of hemostasis
Sight glass processing utensil, carries out the anthemorrhagic operation of Microendoscopic.That is, in ESD, need it is corresponding with purposes (with it is each
Process is corresponding) multiple disposable dedicated processes utensils need corresponding in addition, if there is unexpected bleeding etc.
Processing.Therefore, from the viewpoint of cost and operating time, expectation can correspond to the endoscope-use of multiple processing (process)
Handle utensil.
Therefore, in Japanese Unexamined Patent Publication 2013-111308 bulletins (hereinafter, being denoted as " patent document 2 "), motion has one kind
It can be used in the endoscope-use high-frequency treatment instrument of multiple processing of ESD.
Endoscope-use high-frequency treatment instrument recorded in patent document 2 has the protrusion quantitative change from the front end face of flexible sheath
The knife portion of change.When knife portion is advanced by operation, overhang is being suitble to the position of 2mm of processing for cutting or removing or so to stop,
When knife portion is by back operation, overhang stops in the position for being suitble to label or the 0.5mm of processing of hemostasis or so.By making knife
The overhang in portion corresponds to reason everywhere in ESD and generates variation, need not replace endoscope treatment tool in these processing.Cause
This, improves the operability of operation, shortens operating time.
Utility model content
Figure 11 (a) is to show to cut non-cancer lesion portion using the endoscope-use high-frequency treatment instrument recorded in patent document 2
Around state figure.As shown in Figure 11 (a), in the endoscope-use high-frequency treatment instrument recorded in patent document 2, profit
Mucous membrane is pressed with protrusion member, mucous membrane will not contact the fore-end in knife portion sometimes as a result,.Fore-end in knife portion does not contact
In the case of mucous membrane, the incision of the mucous membrane using fore-end, therefore, the depth shallower for the mucous membrane being cut open are not carried out.In order to
The fore-end in incision knife portion fails the mucous membrane cut, needs that knife portion is inserted into than previous deep position and is repeated same
Operation.The problems such as accordingly, there exist the numbers of incision to increase, operating time is elongated.In order to solve this problem, consider to lengthen knife portion
Overall length.But in this case, due to there is the danger that mucous membrane perforation etc. occurs, the overall length for lengthening knife portion is difficult
's.
The utility model is completed in view of the above circumstances, and its purpose is to provide a kind of endoscope-use high-frequency therapeutic treatments
Utensil is suitble to inhibit the overall length in knife portion elongated, meanwhile, inhibit the increase for cutting number.
Endoscope-use high-frequency treatment instrument involved by one embodiment of the utility model, which can be formed, to be had such as lower part
The composition of part：Flexible sheath is inserted into the processing utensil insert channel of endoscope；Front end component, it is conductive, it is embedded
The front end of flexible sheath；Line, it is conductive, it inserts inside flexible sheath；Rodlike knife portion, it is conductive, it is connected to line
Front end, so that the line is retreated in flexible sheath by operation portion, as a result, from the overhang of the front end face of flexible sheath generate change
Change；Contact portion can connect high frequency electric source, and the high frequency electric source is for making high-frequency current flow into front end component and knife via line
Portion.In this composition, for knife portion, in the position for retreating specified amount from its front end, it is equipped with from the side in the knife portion and protrudes
Protrusion member, when being retreated together with line, protrusion member is connected to front end component, and the fore-end in knife portion is from the front end
The position that the front end face of part protrudes specified amount stops.In addition, for protrusion member, front end side is tapered shape.
As soon as in addition, in the embodiment of the utility model, for protrusion member, such as front end side be conical by its shape or
The shape that person is chamfered.
In addition, in an embodiment of the utility model, protrusion member is configured to, and has base end side relative to knife
The side in portion forms the shape of difference in height.
In addition, in an embodiment of the utility model, front end component is configured to, and has receiving in its front end side
The receiving portion of protrusion member.In this composition, when knife portion retreats together with line, protrusion member is housed in receiving portion, is supported
It is connected to the wall portion for providing the receiving portion and stops, meanwhile, the fore-end in the knife portion is protruding rule from the front end face of front end component
Quantitative position stops.
In addition, in an embodiment of the utility model, range of the above-mentioned specified amount in such as 0.3mm to 0.7mm
It is interior.
An embodiment according to the present utility model provides a kind of endoscope-use high-frequency treatment instrument, is suitble to inhibit knife portion
Overall length it is elongated, meanwhile, inhibit cut number increase.
Description of the drawings
Fig. 1 (a) and Fig. 1 (b) is the endoscope-use Electrosurgical treatment equipment shown involved by an embodiment of the utility model
The outside drawing and sectional view of the composition of tool.
Fig. 2 (a) and Fig. 2 (b) is when showing to make high frequency knife be moved to forefront in an embodiment of the utility model
Endoscope-use high-frequency treatment instrument front end near composition enlarged drawing.
Fig. 3 (a) and Fig. 3 (b) is when showing to make high frequency knife be moved to rearmost in an embodiment of the utility model
Endoscope-use high-frequency treatment instrument front end near composition enlarged drawing.
Fig. 4 is the Section A-A figure of Fig. 2 (b).
Fig. 5 (a), Fig. 5 (b), Fig. 5 (c), Fig. 5 (d) and Fig. 5 (e) are to using involved by an embodiment of the utility model
And endoscope-use high-frequency treatment instrument carry out ESD everywhere in manage the figure illustrated.
Fig. 6 is to show that the endoscope-use high-frequency treatment instrument involved by another embodiment of the utility model has
The side view of the composition of protrusion member.
Fig. 7 is to show that the endoscope-use high-frequency treatment instrument involved by the another embodiment of the utility model has
The side view of the composition of protrusion member.
Fig. 8 is to show that the endoscope-use high-frequency treatment instrument involved by a further embodiment of the utility model has
The side view of the composition of protrusion member.
Fig. 9 (a) and Fig. 9 (b) is to show to make high frequency knife be moved to forefront in a further embodiment of the utility model
When endoscope-use high-frequency treatment instrument front end near composition enlarged drawing.
Figure 10 (a) and Figure 10 (b) is to show to make high frequency knife be moved to finally in a further embodiment of the utility model
The enlarged drawing of composition near the front end of endoscope-use high-frequency treatment instrument when square.
Figure 11 (a) and Figure 11 (b) shows to use existing endoscope-use high-frequency treatment instrument, the utility model respectively
Endoscope-use high-frequency treatment instrument involved by one embodiment cuts the figure of the state around non-cancer lesion portion.
Symbol description
A endoscopes
B lesions
C liquid
D is marked
E ulcer portion
F mucous membranes
The part that G can be cut
The part that H can not be cut.
Specific implementation mode
Hereinafter, the embodiment for being directed at the utility model while with reference to attached drawing illustrates.In addition, in following record
In, as an embodiment of the utility model, illustrated by taking endoscope-use high-frequency treatment instrument as an example.
Fig. 1 (a), Fig. 1 (b) are the endoscope-use high-frequency therapeutic treatment shown involved by an embodiment of the utility model respectively
Outside drawing, the sectional view of the composition of utensil 1.To sum up, as shown in Fig. 1 (a) and Fig. 1 (b), endoscope-use high-frequency treatment instrument
1 has the sheath (flexible sheath) 15 that high frequency knife 12, the line being connect with high frequency knife 12 13, knife 12 and line 13 inserted, is used for
The operation portion 20 etc. of operation lines 13 and sheath 15, sheath 15 insert channel insertion body from the processing utensil of endoscope (not shown)
Intracavitary and the operation for being used in ESD.
High frequency knife 12 is the made of metal component of rodlike (such as pole shapes) such as SUS, for incision/stripping of body cavity inner tissue
Processing etc. and be passed through high-frequency current.High frequency knife 12 is constituted as follows：It is retreated by the operation of operation portion 20, from sheath 15
Front end face overhang generate variation.
Fig. 2 (a) and Fig. 2 (b) and Fig. 3 (a) and Fig. 3 (b) is to show that the front end of endoscope-use high-frequency treatment instrument 1 is attached
The enlarged drawing of close composition.Fig. 2 (a), Fig. 2 (b) be respectively show by operation portion 20 make high frequency knife 12 be moved to as defined in before
Amplification stereogram, the amplification sectional view of state when into position (knife progressive position).Fig. 3 (a), Fig. 3 (b) are to show to lead to respectively
The amplification stereogram for the state that operation portion 20 is crossed when high frequency knife 12 being made to be moved to defined going-back position (knife going-back position), amplification
Sectional view.
As shown in Fig. 2 (a) and Fig. 2 (b) and Fig. 3 (a) and Fig. 3 (b), high frequency knife 12 is in its front end face (knife front end face
12a) nearby it is equipped with from the side of high frequency knife 12 protrusion member 12b outstanding.The base end part of high frequency knife 12 is via connecting component 14
It is electrically connected and is mechanically connected with line 13.
Protrusion member 12b is the made of metal component for the taper for having through hole in central part.The front end of protrusion member 12b
Side is tapering shape, is parabolic conical specifically, as shown in Fig. 2 (a) and Fig. 2 (b) and Fig. 3 (a) and Fig. 3 (b)
Shape.In addition, the base end side of protrusion member 12b is the shape with flat cardinal extremity face.
Protrusion member 12b high frequency knife 12 insert its through hole and from knife front end face 12a retreat specified amount position (such as
The position at the rear of 0.5mm from knife front end face 12a) it is soldered.As a result, in the front end side of protrusion member 12b, 12 He of high frequency knife
Protrusion member 12b is without highly poorly (side of high frequency knife 12 and the parabolic conical shape face of protrusion member 12b are in obtuse angle)
Connection, in the base end side of protrusion member 12b, high frequency knife 12 and protrusion member 12b are in the height poorly (side of high frequency knife 12 and prominent
Play the cardinal extremity face of component 12b at right angles to) connection.In addition, in order to improve the density of high-frequency current, for the outer diameter of high frequency knife 12
Be formed as about 0.3mm carefully as possible.In addition, the outer diameter (most outer diameter) of protrusion member 12b is formed as about 0.6mm.
In an embodiment of the utility model, although high frequency knife 12 and protrusion member 12b are made of the component separated,
But in another embodiment, high frequency knife 12 and protrusion member 12b can also be formed by the component of one.
Line 13 is the made of metal lines such as SUS.Line 13 inserts sheath 15 with following states：The front end of line 13 is by connecting component 14
And it is connected with the cardinal extremity of high frequency knife 12.The cardinal extremity of line 13 extends to operation portion 20.Operator operates operation portion 20 to make line 13
It retreats in sheath 15, high frequency knife 12 and line 13 are integrally retreated as a result, to front end of the high frequency knife 12 relative to sheath 15
The overhang in face (guard leading end face 15a) generates variation.
Connecting component 14 is with the outer diameter bigger and smaller than the internal diameter of sheath 15 than the outer diameter of high frequency knife 12 and line 13
Cylindric made of metal component.In the perforation for being centrally formed with the length direction extension along high frequency knife 12 of connecting component 14
Hole.For the through hole of connecting component 14, the diameter of front end side (12 side of high frequency knife) is slightly larger than the outer diameter of high frequency knife 12, and
And the diameter of base end side (13 side of line) is slightly larger than the outer diameter of line 13.High frequency knife 12, line 13 are respectively in the perforation from connecting component 14
The front end side in hole, base end side by soldering or laser welding etc. are fixed in connecting component 14 after being inserted into.
Fig. 4 is the Section A-A figure of Fig. 2 (b).As shown in Fig. 2 (a) to Fig. 4, it is formed in connecting component 14 from its front end
The slot 14b for the section cross shape that face (connecting component front end face 14a) extends to base end side.Slot 14b is used as and is noted into sheath 15
The sending a part for aquaporin of liquid is supplied to guard leading end face 15a and play a role when entering liquid.
Sheath 15 is to be had absolutely by what the resins such as PTFE (polytetrafluoroethylene, polytetrafluoroethylene (PTFE)) were constituted
The tubular part of edge and flexibility.For sheath 15, about endoscope-use high-frequency treatment instrument 1 relative to endoceliac
The degree of entrance, in order to improve the visual confirmation for utilizing endoscope, the peripheral surface near the 15a of guard leading end face is throughout circumferential
Equipped with marker 16.
By peripheral end (edge part) chamfering of guard leading end face 15a, so that endoceliac mucous membrane will not be because in operation
Sheath 15 action and damage and (form chamfered section 15b.).
Near the 15a of guard leading end face, it is fixed with the metal retainer such as SUS (front end component) 17.Specifically, only
Moving part 17 is the cylinder-like part with the outer diameter roughly the same with the internal diameter of sheath 15, and it is prominent to be formed with anticreep in its peripheral surface
It rises.Retainer 17 is pressed into from guard leading end face 15a in sheath 15 and chimeric with the inner face of sheath 15, in the front end of retainer 17
The position that face (retainer front end face 17a) becomes substantially the same face with guard leading end face 15a is fixed.
On retainer 17, through hole 17c, the perforation are formed with along the length direction (advance and retreat direction) of high frequency knife 12
Hole 17c has the diameter bigger and smaller than the outer diameter of protrusion member 12b than the outer diameter of high frequency knife 12.High frequency knife 12 inserts through hole
17c.In addition, being formed with the protrusion member receiving portion of receiving protrusion member 12b in the sides retainer front end face 17a of retainer 17
17d。
As shown in Fig. 2 (a) and Fig. 2 (b), when operation operation portion 20 makes high frequency knife 12 advance together with line 13, interconnecting piece
Part front end face 14a is connected to the cardinal extremity face (retainer cardinal extremity face 17b) of retainer 17.The protrusion of high frequency knife 12 is limited as a result,
Amount (high frequency knife 12 stops in knife progressive position), high frequency knife 12 will not unnecessarily be protruded from guard leading end face 15a.
As shown in Fig. 2 (a) and Fig. 2 (b), when making high frequency knife 12 advance to knife progressive position, the overhang of high frequency knife 12
For maximum.In an embodiment of the utility model, the maximum overhang of high frequency knife 12 is set as 2mm.Make high frequency knife
12 advance in the state of knife progressive position, and high-frequency current is passed through to high frequency knife 12, and thereby, it is possible to carry out cutting for mucous membrane in body cavity
Open/lift-off processing.
In addition, when supplying liquid (for example, the washing waters such as liquid or physiological saline) into sheath 15, liquid is via slot
14b is supplied to through hole 17c (gap between retainer 17 and high frequency knife 12), is sprayed from guard leading end face 15a to outside
It penetrates.That is, through hole 17c is as the part for sending aquaporin from guard leading end face 15a to outer jet liquid
It plays a role.
As shown in Fig. 3 (a) and Fig. 3 (b), when operation operation portion 20 makes high frequency knife 2 be retreated together with line 13, protrusion
Part 12b is accommodated in protrusion member receiving portion 17d, to which the cardinal extremity face of protrusion member 12b is connected to the receiving of regulation protrusion member
The wall portion of portion 17d, protrusion member 12b stop.High frequency knife 12 and retainer 17 are electrically connected as a result, meanwhile, high frequency knife 12
Position by limitation (high frequency knife 12 knife going-back position stop), the front end of protrusion member 12b and retainer front end face 17a at
For the position on substantially the same face.That is, in knife going-back position, the fore-end of high frequency knife 12 is from guard leading end face
The state of the only prominent 0.5mm of 15a (in other words, retainer front end face 17a).
In addition, the position regardless of high frequency knife 12, retainer 17 always can slidably connect with high frequency knife 12
It touches.That is, retainer 17 can also be configured to, position other than high frequency knife 12 is in knife progressive position, can
It is passed through electricity.
The shape of retainer front end face 17a exposed area and be much larger than high frequency knife 12 and protrusion member 12b.Therefore, it is inciting somebody to action
Protrusion member 12b is contained in the state of the 17d of protrusion member receiving portion, by being passed through high frequency to high frequency knife 12 and retainer 17
Electric current, thereby, it is possible to burn wider area, specifically, processing and hemostasis processing can be marked.
As shown in Fig. 1 (a) and Fig. 1 (b), operation portion 20 has the main body 22 for being fixed with sheath 15 and fixed wired 13 base
The sliding part 24 at end.Main body 22 is bar-like member, the guide groove 22a for being useful for that sliding part 24 is made to slide extended in an axial direction.In master
The ring 22b of finger is hooked when the base end side of body 22 is equipped with for operating.In addition, being equipped with to sheath 15 in the front end side of main body 22
Guide and prevent the anti-bending tube 30 of bending.
Sliding part 24 has the handle 24b that finger is hooked when cylindrical portion 24a and the operation for the periphery for surrounding main body 22.Separately
Outside, the plug (contact portion) 26 being connect with high frequency electric source (not shown) is installed on sliding part 24.The base end part of line 13 is in cylinder
The inside of shape portion 24a is connected and fixed by screw 26a and plug 26.
That is, sliding part 24 and line 13 along guide groove 22a on the length direction of high frequency knife 12 and line 13
It can be slidably mounted to main body 22.Therefore, when operator makes the sliding part 24 of endoscope-use high-frequency treatment instrument 1 to ring 22b
When side is moved, high frequency knife 12 retreats, and protrusion member 12b is accommodated in protrusion member receiving portion 17d (with reference to Fig. 3 (a) and Fig. 3
(b)), when making the sliding part 24 of endoscope-use high-frequency treatment instrument 1 be moved to the guard leading end face sides 15a, high frequency knife 12 advances
(with reference to Fig. 2 (a) and Fig. 2 (b)).In addition, the high-frequency current being passed through from high frequency electric source is via the plug 26 of electric conductivity, line 13, company
Relay part 14 is supplied to high frequency knife 12.
It is equipped with liquid injection port 32 in the base end side (22 side of main body) of anti-bending tube 30.Syringe (not shown) or water supply
Device etc. is connect with liquid injection port 32, to which the liquid such as liquid or washing water are injected liquid injection port 32, as a result, to shield
Liquid is supplied in set 15.
Supply is flowed in sheath 15 to the liquid in sheath 15 and is sent to the guard leading end face sides 15a, and shape is supplied to
At slot 14b, the through hole 17c (gap between retainer 17 and high frequency knife 12) in connecting component 14.When make high frequency knife 12 from
When knife going-back position is prominent (with reference to Fig. 3 (a) and Fig. 3 (b)), the front end of through hole 17c is opened, therefore, from guard leading end face
15a sprays liquid.The liquid sprayed from guard leading end face 15a is used as the high frequency knife in incision/lift-off processing of mucous membrane in body cavity
The local injection liquid of 12 cleaning and local injection treatment.
Then, to using the ESD hands of the endoscope-use high-frequency treatment instrument 1 involved by an embodiment of the utility model
Art illustrates.Fig. 5 (a), Fig. 5 (b), Fig. 5 (c), Fig. 5 (d) and Fig. 5 (e) are that explanation uses endoscope-use high-frequency treatment instrument 1
The figure managed everywhere in the ESD of progress.
[label]
Fig. 5 (a) is to using the endoscope-use high-frequency treatment instrument 1 involved by an embodiment of the utility model to carry out
Label handle the figure that illustrates.Label processing is following process：Forward end section of endoscope is inserted into the body cavity of patient,
The mark of range is cut as the lesion periphery mark of the incision object of ESD.
Operator inserts in the case where forward end section of endoscope is inserted into the endoceliac state of patient to the processing utensil of endoscope
Circulation passage inserts sheath 15, and sheath 15 is made to be protruded from endoscope distal end portion.Operator is confirmed by endoscopic images on one side
The position of guard leading end face 15a and lesion make high frequency knife 12 retreat to knife going-back position (with reference to Fig. 3 (a) and Fig. 3 on one side
(b)), in this state, guard leading end face 15a is pressed on to the mucous membrane on lesion periphery, and high-frequency electrical is passed through to high frequency knife 12
Stream.
In knife going-back position, the high-frequency current for being supplied to high frequency knife 12 is also supplied to retainer 17.Therefore, mainly
It is that the mucous membrane contacted with the exposed portion of retainer front end face 17a is cauterized, to form label trace.
In addition, in knife going-back position, the fore-end of high frequency knife 12 protrudes 0.5mm from guard leading end face 15a.Therefore, when
When guard leading end face 15a is pressed against the mucous membrane on lesion periphery, high frequency knife 12 is slightly inserted into mucous membrane.High frequency knife as a result,
12 will not skid in mucous membrane surface, and operator can form label trace in target location.
Above-mentioned operation is repeated several times in operator, forms the label trace of the number of the degree for the outer rim that can hold lesion
Mark terminates label processing.
In addition, in label processing, if logical to high frequency knife 12 in the state that guard leading end face 15a is pressed against mucous membrane
If entering high-frequency current, it is likely that (main in the part contacted with mucous membrane being energized in component for being passed into high-frequency current
It is retainer front end face 17a) adhere to because burning the attachments such as thermoset hemochrome or protein.
Therefore, for endoscope-use high-frequency treatment instrument 1, the component of mucous membrane may be pressed against in handling ESD
Implement the nonpolluting coating for preventing from burning in surface.Specifically, to the high frequency knife 12, prominent in endoscope-use high-frequency treatment instrument 1
It rises and appears in apparent main surface region implementation nonpolluting coating in component 12b and retainer 17.As coating side
Method, for example, coating method, dip coating, spray coating method etc. can be enumerated.
Fig. 9 (a), Fig. 9 (b) are endoscope-use high-frequency therapeutic treatment when showing for high frequency knife 12 to be moved to knife progressive position respectively
Amplification stereogram, the amplification sectional view of composition near the front end of utensil 1.In Fig. 9 (a) and Fig. 9 (b), with hacures table
The region shown is the surface region for implementing nonpolluting coating.In addition, Fig. 9 (a) and Fig. 9 (b) (and aftermentioned Figure 10 (a) and
Figure 10 (b)) in, for the ease of expressing the surface region for implementing nonpolluting coating, (even for example cutting other than the surface region
Face) do not use hacures.
As the material of nonpolluting coating, such as use the compatibility of the carbon generated when being carbonized with body cavity inner tissue because burning
Low material.For example, fluoride (テ Off ロ Application (registered trademark)) or silicon oxide compounds (titanium dioxide can be used
Silicon), organo-silicon compound (silicone) etc..
By implementing nonpolluting coating to region shown in Fig. 9 (a) and Fig. 9 (b), in label processing, protein etc. is attached
Object to be difficult to be attached to endoscope-use high-frequency treatment instrument 1.Thus, it is difficult to which obstruction is handled due to attachment, and therefore, operator is easy
In progress processing appropriate.In addition, for the attachment not removed completely by the washing water sprayed from guard leading end face 15a, need
Sheath 15 is taken out from endoscope to clean.Due to nonpolluting coating, attachment becomes difficult to adhere to, as a result, time of the operation
Number is reduced, and therefore, shortens operating time.
In addition it is also possible to not to the surface region of high frequency knife 12, protrusion member 12b, retainer 17 these all components
Implement nonpolluting coating.If appearing in pair the high frequency knife 12 and retainer 17 wide with the contact area of mucous membrane is apparent extremely
At least part of surface region (wherein, especially retainer front end face 17a) implements nonpolluting coating, and can also be inhibited attachment
The effect of the attachment of object.
[local injection]
Fig. 5 (b) is to using the endoscope-use high-frequency treatment instrument 1 involved by an embodiment of the utility model to carry out
Local injection handle the figure that illustrates.Local injection processing is following process：To as the glutinous of the lesion for cutting object
Film lower layer local injection liquid makes the mucous membrane as the lesion for cutting object float.
Operator confirms the position of guard leading end face 15a and lesion by endoscopic images on one side, makes high frequency on one side
Knife 12 is passed through high-frequency current in the state of advancing to knife progressive position (with reference to Fig. 2 (a) and Fig. 2 (b)), and break-through is used for sheath
Front end face 15a is inserted into the hole of submucosa.Then, operator makes high frequency knife 12 retreat to knife going-back position (with reference to Fig. 3 (a)
With Fig. 3 (b)) in the state of by guard leading end face 15a be inserted into submucosa.When guard leading end face 15a is inserted into submucosa,
Operator injects liquid from liquid injection port 32, and operates sliding part 24 in this state, and high frequency knife 12 is made slightly to advance.
[incision]
Fig. 5 (c) is to using the endoscope-use high-frequency treatment instrument 1 involved by an embodiment of the utility model to carry out
Incision handle the figure that illustrates.It is following process to cut processing：Being cut along label trace becomes the lesion for cutting object
Around portion.
Operator confirms guard leading end face 15a by endoscopic images on one side and marks the position of trace, makes height on one side
Before frequency knife 12 advances to knife progressive position (with reference to Fig. 2 (a) and Fig. 2 (b)) and makes sheath in the state of so that high-frequency current is passed through
End face 15a is moved along label trace, to carry out full incision.
Figure 11 (b) is the endoscope-use high-frequency treatment instrument 1 for showing to use involved by an embodiment of the utility model
Cut the figure of the state around non-cancer lesion portion.As shown in Figure 11 (b), for protrusion member 12b, cardinal extremity face and high frequency knife
12 side is orthogonal and forms difference in height.The difference in height is embedded in mucous membrane, is played a role as a kind of anticreep means.Therefore,
In incision (during being moved it in the state of making in knife front end face 12a embedment mucous membranes), knife front end face 12a will not be from glutinous
Film surprisingly falls off.
In addition, as shown in Figure 11 (b), the front end side of protrusion member 12b and high frequency knife 12 are without highly poorly (high frequency knife 12
Side and the parabolic conical shape face of protrusion member 12b are in obtuse angle) connection.Therefore, in incision, mucous membrane is contacted to high frequency knife
The near border of 12 side and the parabolic conical shape face of protrusion member 12b.Therefore, high frequency knife 12 is from guard leading end face
The mucous membrane of the depth of the overall length (2mm) of 15a protrusions outstanding is cut open.That is, according to the present utility model one is real
Mode is applied, necessary depth (being herein 2mm) can be cut in the case where not increasing the overall length of high frequency knife 12.It is therefore prevented that
The generation of mucous membrane perforation etc., simultaneously, it is suppressed that the number of incision, in turn, it is suppressed that the long-time of operation.
In incision processing, mostly with bleeding.In the case of bleeding, operator carries out aftermentioned hemostasis processing.In addition,
In incision processing, since mucous membrane and blood etc. are attached to high frequency knife 12, it may occur that the function reduction as knife is this
Situation.In this case, operator temporarily extracts high frequency knife 12 from mucous membrane, and injects liquid from liquid injection port 32
Clean knife front end face 12a.That is, an embodiment according to the present utility model, can not take out endoscope-use high frequency
Knife front end face 12a is cleaned in the case of handling utensil 1, further, it is possible to carry out hemostasis processing.
In local injection/incision processing, also due to nonpolluting coating, the attachments such as protein are difficult to be attached to endoscope-use
High-frequency treatment instrument 1.In local injection/incision processing, mainly high frequency knife 12 or protrusion member 12b is contacted with mucous membrane.I.e.
Make, in the case where attachment is attached to high frequency knife 12 or protrusion member 12b, also easily can directly spray to these components
Washing water.Therefore, in local injection/incision processing, for attachment, the removal carried out using washing water is effective.
In addition, comparing the thickness for the nonpolluting coating that retainer 17 is implemented to the thickness of the nonpolluting coating of the implementation of high frequency knife 12
It is thin.By keeping the coating layer thickness relative to high frequency knife 12 thinning, it is suppressed that the protruding portion of the high frequency knife 12 in knife progressive position
The influence (that is, amount of the only elongated coating layer thickness of overall length) for the overall length (2mm) divided.This from prevent mucous membrane perforation etc. generation viewpoint
Set out is also to be suitble to.
[stripping]
Fig. 5 (d) is to using the endoscope-use high-frequency treatment instrument 1 involved by an embodiment of the utility model to carry out
The figure that illustrates of lift-off processing.Lift-off processing is the process for removing the lesion of incision bit by bit.
Operator makes high frequency knife 12 advance to knife progressive position (with reference to Fig. 2 (a) and Fig. 2 (b)) and is being passed through high-frequency electrical
In the state of stream, lift the lesion of incision on one side, burns the submucosa of the lesion of incision on one side to be removed.It is shelling
From in processing, also in incision processing in the same manner as, protrusion member 12b is suitably hung in mucous membrane.Therefore, high frequency knife will not occur
12 skid and the case where surprisingly fall off from mucous membrane.
In lift-off processing, also due to nonpolluting coating, the attachments such as protein are difficult to be attached to endoscope-use high-frequency therapeutic treatment
Utensil 1.In lift-off processing, also in the processing of local injection/incision in the same manner as, mainly high frequency knife 12 or protrusion member 12b
It is contacted with mucous membrane.Therefore, for attachment, the removal carried out using washing water is effective.
[hemostasis]
Fig. 5 (e) is to using the endoscope-use high-frequency treatment instrument 1 involved by an embodiment of the utility model to carry out
Hemostasis handle the figure that illustrates.Hemostasis processing is following processing：By to after lesion is removed ulcer portion and
The bleeding part of bleeding carries out calcination to stop blooding in incision, lift-off processing.
Operator will protect in the state of so that high frequency knife 12 is retreated to knife going-back position (with reference to Fig. 3 (a) and Fig. 3 (b))
Set front end face 15a presses on ulcer portion or the mucous membrane of bleeding, is passed through high-frequency current to high frequency knife 12 and is burnt.With mark
Similarly, in knife going-back position, the high-frequency current for being supplied to high frequency knife 12 is also supplied to retainer 17 to reason.Therefore, with only
The mucous membrane of the wide area of comparison of the exposed portion contact of moving part front end face 17a is cauterized, to carry out hemostasis processing.
In addition, in knife going-back position, the fore-end of high frequency knife 12 protrudes 0.5mm from guard leading end face 15a.Therefore, when
When guard leading end face 15a is pressed against the mucous membrane on lesion periphery, high frequency knife 12 is slightly inserted into mucous membrane.High frequency knife as a result,
12 will not skid in mucous membrane surface, and therefore, operator can correctly stop blooding to target location.
In hemostasis processing, also due to nonpolluting coating, the attachments such as protein are difficult to be attached to endoscope-use high-frequency therapeutic treatment
Utensil 1.Therefore, processing is difficult to be attached to object obstruction, and operator is easy to carry out processing appropriate.
Operator continues above-mentioned action (processing) as needed, final disposable excision lesion, using with pliers
The recycling excision such as other processing utensils after mucous membranes, complete the operation of ESD.
It is the explanation of the illustrative embodiments of the utility model above.The embodiment of the utility model is not limited to
Bright mode is stated, various deformations can be carried out in the range of the technological thought of the utility model.For example, by explanation
Content obtained from exemplary embodiment expressed etc. or the progress such as obvious embodiment are appropriately combined in book
Included in the embodiment of the utility model.For example, in the above-described embodiment, protrusion member 12b is set to and knife
The base end side of front end face 12a distances 0.5mm, but it's not limited to that for the utility model.In another embodiment, can also
By protrusion member 12b be set to in the range of knife front end face 12a distances 0.3mm~0.7mm.
In addition, in the above-described embodiment, the tapered shape of the front end side as protrusion member 12b and list parabolic
Line conical by its shape, but it's not limited to that for the utility model.Fig. 6 to Fig. 8 shows the protrusion with other tapered shapes
The side view of part 12b.As shown in fig. 6, protrusion member 12b may be the taper portion of the tapered shape with linear conical by its shape
Part.In addition, as Fig. 7, Fig. 8 are respectively shown in, protrusion member 12b is disc-shaped part, and by the way that front end surface side is carried out R chamferings, C falls
Angle can also be formed as actually tapering shape.
In addition, the tapered shape of protrusion member 12b is not limited to parabolic conical shape or linear conical by its shape, is fallen
The shape at angle.For example, the tapered shape of protrusion member 12b, which can be exponential function conical by its shape, either can pass through it
The shape that his function defines, alternatively, can also be the shape for being similar to these functions.
In addition, in Figure 10 (a) and Figure 10 (b), it is high that the endoscope-use involved by a further embodiment is illustrated with amplification
Composition near the front end of frequency processing utensil 1.In Figure 10 (a) and Figure 10 (b), show after so that high frequency knife 12 is moved to knife
It gives up the throne the state set.
As shown in Figure 10 (a) and Figure 10 (b), the protrusion member 12b involved by a further embodiment is formed as discoid.
When making high frequency knife 12 be moved to knife going-back position, it is accommodated in the front end face of the protrusion member 12b of protrusion member receiving portion 17d
It is located on substantially the same face with retainer front end face 17a.That is, in a further embodiment, in label processing and only
Blood processing in, on the retainer front end face 17a substantially the same faces wide with the contact area of mucous membrane, exist equally with mucous membrane
The front end face of the wide protrusion member 12b of contact area.Therefore, worry that attachment is attached on these faces.Therefore, further implementing
In mode, in Figure 10 (a) and Figure 10 (b), nonpolluting coating is implemented for the surface region indicated with hacures.Even if as a result,
It is that also can suitably inhibit the attached of attachment with the wide composition of the contact area of mucous membrane as Figure 10 (a) and Figure 10 (b)
It.
Claims (5)
1. a kind of endoscope-use high-frequency treatment instrument, which is characterized in that have：
Flexible sheath is inserted into the processing utensil insert channel of endoscope；
Front end component, conductive, the front end of the embedded flexible sheath；
Line, it is conductive, it inserts inside the flexible sheath；
Rodlike knife portion, it is conductive, it is connected to the front end of the line, makes the line in the flexible sheath by operation portion
It retreats, generates variation from the overhang of the front end face of the flexible sheath as a result,；
Contact portion can connect high frequency electric source, and the high frequency electric source is for making high-frequency current flow into the front end via the line
Component and the knife portion,
For the knife portion, in the position for retreating specified amount from the front end in the knife portion, it is equipped with prominent from the side in the knife portion
The protrusion member gone out, when being retreated together with the line, the protrusion member is connected to the front end component, before the knife portion
End part stops in the position for protruding specified amount from the front end face of the front end component,
For the protrusion member, front end side is tapered shape.
2. endoscope-use high-frequency treatment instrument according to claim 1, which is characterized in that
For the protrusion member, front end side is conical by its shape or the shape being chamfered.
3. endoscope-use high-frequency treatment instrument according to claim 1 or 2, which is characterized in that
The protrusion member has the shape that base end side forms difference in height relative to the side in the knife portion.
4. endoscope-use high-frequency treatment instrument according to claim 1, which is characterized in that
For the front end component, there is the receiving portion for accommodating the protrusion member in the front end side of the front end component,
When the knife portion retreats together with the line, the protrusion member is housed in the receiving portion, is connected to regulation
The wall portion of the receiving portion and stop, meanwhile, the fore-end in the knife portion is protruding specified amount from the front end face of the front end component
Position stop.
5. endoscope-use high-frequency treatment instrument according to claim 1, which is characterized in that
The specified amount is in the range of 0.3mm to 0.7mm.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2016-004573 | 2016-01-13 | ||
| JP2016004573A JP6655398B2 (en) | 2016-01-13 | 2016-01-13 | High frequency treatment tool for endoscope |
| PCT/JP2017/000395 WO2017122607A1 (en) | 2016-01-13 | 2017-01-10 | High-frequency treatment device for endoscope |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN207666692U true CN207666692U (en) | 2018-07-31 |
Family
ID=59312084
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201790000013.6U Active CN207666692U (en) | 2016-01-13 | 2017-01-10 | Endoscope-use high-frequency treatment instrument |
Country Status (3)
| Country | Link |
|---|---|
| JP (1) | JP6655398B2 (en) |
| CN (1) | CN207666692U (en) |
| WO (1) | WO2017122607A1 (en) |
Families Citing this family (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108523985B (en) * | 2018-04-23 | 2024-05-07 | 南微医学科技股份有限公司 | Multifunctional high-frequency electric incision knife |
Family Cites Families (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH0234885Y2 (en) * | 1985-09-17 | 1990-09-20 | ||
| JP4495501B2 (en) * | 2004-03-31 | 2010-07-07 | Ｈｏｙａ株式会社 | Endoscopic treatment tool for endoscope |
| JP4495492B2 (en) * | 2004-03-24 | 2010-07-07 | Ｈｏｙａ株式会社 | Endoscopic treatment tool for endoscope |
| JP4692141B2 (en) * | 2005-08-12 | 2011-06-01 | 富士フイルム株式会社 | High frequency treatment tool |
| JP5048391B2 (en) * | 2007-04-27 | 2012-10-17 | 直久 矢作 | Endoscopic treatment tool |
| JP5111931B2 (en) * | 2007-05-07 | 2013-01-09 | オリンパスメディカルシステムズ株式会社 | Endoscopic treatment tool |
| JP2009090003A (en) * | 2007-10-11 | 2009-04-30 | Fujinon Corp | High-frequency treatment instrument for endoscope |
| JP5114333B2 (en) * | 2008-08-01 | 2013-01-09 | Ｈｏｙａ株式会社 | Endoscopic treatment tool |
| JP2010213946A (en) * | 2009-03-18 | 2010-09-30 | Fujifilm Corp | High frequency treatment instrument |
| JP5755121B2 (en) * | 2011-11-30 | 2015-07-29 | Hoya株式会社 | Endoscopic high-frequency treatment instrument |
-
2016
- 2016-01-13 JP JP2016004573A patent/JP6655398B2/en active Active
-
2017
- 2017-01-10 WO PCT/JP2017/000395 patent/WO2017122607A1/en active Application Filing
- 2017-01-10 CN CN201790000013.6U patent/CN207666692U/en active Active
Also Published As
| Publication number | Publication date |
|---|---|
| WO2017122607A1 (en) | 2017-07-20 |
| JP6655398B2 (en) | 2020-02-26 |
| JP2017123995A (en) | 2017-07-20 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| EP2050409B1 (en) | High frequency tool | |
| JP5755121B2 (en) | Endoscopic high-frequency treatment instrument | |
| KR100595803B1 (en) | High-frequency knife and endoscopic apparatus | |
| JP5775989B1 (en) | Endoscopic high-frequency treatment instrument | |
| JP4836492B2 (en) | High-frequency treatment instrument and mucosal detachment method using the high-frequency treatment instrument | |
| JP4600683B2 (en) | High frequency treatment tool | |
| JP4692141B2 (en) | High frequency treatment tool | |
| JP5415727B2 (en) | Endoscopic treatment tool | |
| KR20040090468A (en) | Radio knife | |
| JPWO2014042039A1 (en) | High frequency knife | |
| JP5751749B2 (en) | Endoscopic treatment tool | |
| US20100241118A1 (en) | High frequency treatment instrument | |
| CN206809326U (en) | Endoscope-use high-frequency treatment instrument | |
| JP4965416B2 (en) | High frequency treatment tool | |
| JP2009090003A (en) | High-frequency treatment instrument for endoscope | |
| CN207666692U (en) | Endoscope-use high-frequency treatment instrument | |
| US9168095B2 (en) | High-frequency treatment device | |
| JP2023067784A (en) | Endoscope treatment tool | |
| JP2007275625A (en) | High frequency treatment instrument | |
| JP2009118891A (en) | High frequency treatment instrument for endoscope | |
| JP2006115966A (en) | High-frequency treatment instrument for endoscope | |
| JP2007260314A (en) | Treatment implement for endoscope | |
| JP4431892B2 (en) | High frequency treatment tool | |
| JP2007313344A (en) | High-frequency treatment instrument | |
| JP2009118890A (en) | High-frequency treatment tool for endoscope |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| GR01 | Patent grant | ||
| GR01 | Patent grant |