JP2000254147A - Thermocauterectomy instrument with handle - Google Patents

Abstract

PROBLEM TO BE SOLVED: To surely collect plural polyps to the outside of the body with a single endoscope insertion once by constituting a thermocaurterectomy instrument of a sheath having plural inner cavities, a resecting operation member, a thermocauterectomy instrument, a grasping operation member to be put through a sub-inner cavity and a grasping tool having a grasping part in an exposure part to the outside of the sheath. SOLUTION: The sheath 1 is provided with the three inner cavities, the resecting operation part is arranged at a base end, the base end of the resecting operation member 2 which is put through a main inner cavity is connected and a loop shape wire to be a resecting part 3 is connected to the tip of the operation member 2. When this is drawn into the sheath 1, it is elastically deformed, crushed to be thin and long, protruded and extended in a loop shape. Besides, the grasping operation member 5 is put through the sub-inner cavity which is independent of the main cavity, the handle part 7 for forming the loop is joined to the tip through a through-hole 6 and the tip is fixed to the tip of the sheath 1. Then the grasping operation part at the sheath base end, where the base end of the member 5 is connected, is moved forward/ backward so that the loop of the handle part 7 is opened/closed and, then, one polyp is grasped by one grasping part.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a cautery cutting device with a gripper which is inserted endoscopically into a body cavity, removes a polyp in the body cavity by high-frequency current, and recovers the polyp outside the body.

[0002]

2. Description of the Related Art A so-called polypectomy, in which a polyp is squeezed by a loop-shaped wire (snare) and cut by energization, has been practiced for a long time. When collecting the resected polyp outside the body, grasp the polyp using a snare, or remove the snare from the endoscope once and grasp the polyp with a so-called grasping forceps as shown in FIG. 1, or The endoscope had to be pulled out of the body together with the endoscope by using a suction mechanism of the endoscope to adsorb a polyp at the tip of the forceps outlet.

[0003] Therefore, when a plurality of polyps are collected, in the above-described method, the endoscope must be inserted into the patient by the number of polyps, so that the treatment time is prolonged. However, there is a problem that the pain to the patient increases due to the insertion of the endoscope.

[0004] As a method of cutting and collecting a plurality of polyps by inserting the endoscope once, there is a suction and collection method.
This is a method in which a snare is once removed from an endoscope after a polyp is excised, and the polyp is collected outside the body from a forceps hole by suction. Therefore, recoverable polyps are
There is a problem that the polyp is a relatively small polyp that can pass through the forceps hole, and the polyp is damaged due to the passage of the forceps hole, thereby hindering the tissue examination.

[0005] When a plurality of polyps are collected at once with a collection bag as shown in FIG. 2 disclosed in Japanese Patent Application Laid-Open No. 5-115493, the operation is shifted to the collection operation after all the polyps are cut off. I have to do it. This is because the snare must be removed from the endoscope in order to use the collection bag. Therefore, there is a fatal drawback that the resected polyp is easily lost because the polyp cannot be recovered immediately after resection. further,
Due to its structure, there is also a problem in operability that the collected polyps are dropped in the bag at the time of collecting the next polyp.

[0006]

SUMMARY OF THE INVENTION The present invention solves the above-mentioned problems of polypectomy in conventional endoscopic procedures, and allows a plurality of polyps to be collected outside the body by inserting the endoscope once. It is an object of the present invention to provide a cautery resection tool with a gripping tool that can be reliably performed.

[0007]

According to the present invention, there are provided (1) a sheath having a plurality of lumens, (2) an operating member for resection inserted through the main lumen, and (3) a distal end of the operating member. A cautery resection tool made of a wire formed in a loop shape, (4) a grasping operation member inserted through the sub-lumen, and (5) a sheath joined to the distal end of the operation member and out of the sheath near the sheath distal end. A cautery resection tool with a gripper, comprising a gripper having a grip portion at an exposed portion of the tool.

[0008]

DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, the present invention will be described in detail with reference to embodiments. FIG. 3 is a schematic view showing an embodiment of a cautery resection tool with a gripper according to the present invention, FIG. 4 is a cross-sectional view taken along line AA ′ of FIG. 3, and FIG. The figure of the
FIG. 6 is a view showing an example in which a polyp is excised by a cautery resection tool with a gripper, FIG. 7 is a view showing an example in which the polyp is gripped, and FIG. 8 is another view in a state in which the polyp is gripped. FIG. 3 is a diagram showing an example in which polyp resection is performed.

In FIG. 3, a sheath (1) is made of a flexible tube and has three lumens. Although not shown, a proximal end of the sheath is provided with an operating portion for resection, and a main lumen (8) is provided.
The base end of the operating member for resection (2) inserted so as to be able to move forward and backward is connected. Further, a wire having a loop-shaped opening habit as a resection portion (3) is connected to the distal end of the resection operation member (2). When the wire is pulled into the sheath (1), the wire is elastically deformed. When it is squashed and protruded from the distal end of the sheath (1), it expands in a loop.

In the secondary lumen (4) different from the main lumen (8),
A grasping operation member (5) is inserted so as to be able to advance and retreat, and a distal end of the grasping operation member (5) is a through-hole at an exposed portion to the outside of the sheath (1) near the distal end of the sheath (1). A grip (7) forming a loop is joined via (6), and the distal end of the grip (7) is fixed to the distal end of the sheath (1). The loop of the gripper (7) can be opened and closed by moving the gripping operation unit (not shown) provided at the base end of the sheath (not shown) to which the base end of the gripping operation member (5) is connected. Thus, one polyp can be gripped by one gripper (7).

The number of sub-lumens (4) into which the gripping operation member (5) is inserted, that is, the number of gripping portions (7) is preferably 2 to 4, more preferably 2 to 3. Because, depending on the size of the polyp, when grasping five or more polyps, when removing the endoscope out of the body, that is, when collecting the polyp outside the body, both the polyp and the patient's body cavity Significant resistance is likely to cause damage to the polyp and increase the likelihood that the patient will feel pain. Further, when the number of gripping portions is set to five or more, the sheath (1)
Since the outer diameter is bulky, a sufficient clearance with the forceps hole cannot be formed, and the possibility of obstructing the suction mechanism of the endoscope is increased, which is not preferable. This is because in polypectomy, body fluid around the polyp must be removed by aspiration before excision in order to prevent thermal damage to parts other than the polyp due to energization during excision.

If the number of the gripping portions (7) is smaller than two, the number of polyps that can be gripped is reduced to two or less even in consideration of the gripping of the resection portion (3) with a wire. This is not preferable because the usefulness from the viewpoint of the above becomes low.

When the gripping portion (7) and the gripping operation member (5) are formed and joined with different materials, the materials can be selected in consideration of the loop formability and operability, respectively.
In addition, it is preferable that the grip portion (7) and the gripping operation member (5) are made of a continuous body made of the same material, because the manufacturing cost can be reduced and the manufacturing can be easily performed.

According to the method of forming a loop of the grip portion (7) according to the present invention, the outer wall of the sub-lumen (4) into which the gripping operation member (5) is inserted is cut and exposed outside the sheath (1). A hole (6) is formed and formed through the through hole (6). This is to form a loop on the same circle center,
The polyp is completely surrounded by an open loop, and the grip is closed by pulling the gripping operation unit toward the user, thereby securely gripping the polyp. Further, the loop of the grip portion (7) is not limited to a single line, but may be a double line or a triple line, so that the contact area with the polyp can be increased and more reliable gripping can be performed.

The method of forming the through hole (6) is not limited to the above, and the loop of the holding portion (7) is formed on the same center of the circle. It may be made by joining a small-diameter ring (9) or the like to the exposed portion on the side near the distal end of the sheath (1). In this case, the bulk of the closed loop is not limited by the thickness of the sheath (1), and there is an advantage that the loop can be made smaller, which is preferable.

Next, a method of performing actual excision / recovery using the cautery excision device with a gripper according to the present invention will be described, and the usefulness of the present invention will be clarified. FIG. 6 is a view showing a polyp (10) being cut using the cautery cutting tool with a gripper according to the present invention. Here, the wire which is the resection part (3) is hooked on the polyp (10), and electricity is supplied to perform ablation and resection. The root of the polyp (10) is tightened by pulling the cut portion (3) into the sheath (1).

FIG. 7 is a view showing a state in which the excised polyp (10) is gripped by the gripper (7) on the side near the distal end of the sheath (1). Since the polyp (10) can be grasped immediately after resection, the resected polyp (1
0) is less likely to be lost and the loop of the gripper (7) can grip the polyp all around, so that the gripping operation is easy.

FIG. 8 is a view showing a state in which another polyp (11) is being excised while holding the excised polyp (10). In this way, a plurality of polyps can be grasped continuously for each resection without removing the endoscope.

[0019]

As is evident from the above, the cautery resection tool with a gripper according to the present invention is extremely useful because a plurality of polyps can be reliably recovered by inserting the endoscope once.

[Brief description of the drawings]

FIG. 1 is a view showing a grasping forceps.

FIG. 2 is a view showing a collection bag.

FIG. 3 is a schematic view showing an embodiment of a cautery resection tool with a gripper according to the present invention.

FIG. 4 is a sectional view taken along line A-A 'of FIG.

FIG. 5 is a view showing a through hole according to another embodiment of the present invention.

FIG. 6 is a schematic view showing an embodiment in which a polyp is cut by a cautery cutting tool with a gripper according to the present invention;

FIG. 7 is a schematic view showing an embodiment in which a excised polyp is gripped by the cautery cutter with gripper according to the present invention.

FIG. 8 is a schematic view showing an embodiment in which another polyp is cut while holding the cut polyp by the cautery cutting tool with a gripper according to the present invention.

[Explanation of symbols]

 1. Sheath 2. Operation member for resection Resection part 4. Secondary lumen 5. Operation member for gripping 6. Through hole 7. Grip part 8. Main lumen 9. Ring 10. Polyps 11. Another polyp

Claims (4)

[Claims] 1. A sheath having a plurality of lumens.
(2) an operating member for resection inserted into the main lumen; (3) a cautery resection tool made of a wire formed in a loop fixed to the tip of the operating member; A cautery resection tool with a gripper, comprising: a gripping operation member; and (5) a gripper joined to the distal end of the operation member and having a gripper at an exposed portion outside the sheath at a portion near the sheath distal end. . 2. The sheath according to claim 1, wherein the grip portion is a portion exposed to the outside of the sheath near the sheath distal end, forms a loop that can be opened and closed via a through hole, and the distal end is fixed to the sheath distal end. Cautery resection tool with gripper. 3. The cautery resection tool with a grasping tool according to claim 2, wherein the through hole is formed by joining a part having a diameter smaller than the diameter of the sub-lumen to the exposed part. 4. The cautery resection tool with a gripper according to claim 1, wherein the gripper and the gripping operation member are continuous bodies made of the same material.