JP2000271132A - Medical implement - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a medical implement allowing an operator to operate an operating wire for driving the treatment part lightly by reducing the friction resistance between the outer surface of the operating wire and the inner surface of the sheath. SOLUTION: This medical implement has a long sheath 2, a treatment part 13 disposed at the top of the sheath 2, an operating part 4 disposed at the handling end of the sheath 2, and an operating bar 8 inserted into the sheath 2 for transmitting the drive force to the treatment part 13. In the medical implement, the outer surface of the operating bar 8 is coated at least partly with a resin outer layer, and fine irregularity is formed at least partly on the outer surface of the outer layer for improving the slidability between the outer layer and the sheath 2.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical instrument such as a treatment tool for an endoscope, and more particularly, to transmitting a driving force to a treatment section through a transmission member inserted from an operation section into a long sheath. Medical equipment.

[0002]

2. Description of the Related Art Generally, a treatment tool for an endoscope includes an elongated sheath which is inserted into a channel of the endoscope and introduced into a body cavity. A treatment section is provided at the distal end of the sheath, and the treatment section is driven by pushing and pulling an operation wire inserted into the sheath from a hand operation section. As described above, in order to open and close the treatment section at the distal end of the sheath, for example, the biopsy cup, the operating wire inserted into the sheath is pushed and pulled to operate the treatment section at the distal end. In use, when operating the treatment section, the operation wire in the sheath moves, but at this time, frictional resistance is generated between the operation wire and the inner surface of the sheath. In particular, if the sheath is meandering or curved, the frictional resistance between the inner surface of the sheath and the operation wire increases, and a large amount of force is required to pull and advance the operation wire.
In extreme cases, the operation wire may not move. In such a case, the amount of force applied to the operation unit is not transmitted to the forceps unit, so that the cup cannot be freely operated and an accurate biopsy operation cannot be performed.

[0003]

SUMMARY OF THE INVENTION US Patent 5,571,
No. 129 proposes a method of applying a resin coating to the outer peripheral surface of an operation wire.

However, in order to prevent the operation wire from being contaminated, the outer periphery of the operation wire is coated with a resin, and the wire is simply sealed. The clearance between the wire and the inner surface of the sheath decreases. As a result, the movement of the operation wire is more inhibited than before the resin coating is applied, and the operation wire is less likely to move.

[0005] In addition to the above-mentioned prior art, a technique for coating the outer peripheral surface of the operation wire with a resin is disclosed in German Utility Model No. G82030264, for insulation purpose. No. 160010, for the purpose of preventing buckling of the operation wire, and for the purpose of improving the suction performance by sealing around the operation wire, which is known from Japanese Utility Model Application Laid-Open No. 54-18992. and so on. However, none of them considers the easiness of movement of the operation wire, and none of them is satisfactory with respect to the operability of the operation wire.

SUMMARY OF THE INVENTION The present invention has been made in view of the above problems, and has as its object to reduce the frictional resistance between the outer surface of the operation wire and the inner surface of the sheath and to operate the operation wire for driving the treatment section. An object of the present invention is to provide a medical device that can perform the operation of the medical device with a light force.

[0007]

According to the first aspect of the present invention, there is provided an elongate sheath, a treatment section disposed at a distal end of the sheath, an operation section disposed near the sheath.
A transmission member inserted into the sheath and transmitting a driving force from the operation section to the treatment section, wherein at least a part of an outer surface of the transmission member is covered with a resin outer layer, and the outer layer A medical device characterized in that minute irregularities are formed on at least a part of the outer surface of the device so as to enhance the slidability with the sheath.

According to a second aspect of the present invention, the transmitting member includes:
The medical device is a flexible metal wire, and the sheath is a coil.

According to a third aspect of the present invention, there is provided a medical device characterized in that the small irregularities have an average drop of 1 to 15 microns.

According to the present invention, the minute irregularities formed on the outer surface of the resin coating reduce the contact area between the inner surface of the sheath and the outer surface of the transmission member, and reduce the frictional resistance between the two, thereby reducing the medical resistance. The operation of the instrument becomes lighter.

[0011]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS First Embodiment A surgical incision forceps according to a first embodiment of the present invention will be described with reference to FIGS. 1, 2, 3 and 4. FIG.

(Structure) FIG. 1 shows an incision forceps 1 for a surgical operation.
The incision forceps 1 has a sheath 2 formed of a straight rigid tube, and the portion of the sheath 2 is used as an insertion portion for introducing into a body cavity.

An operation section 4 having a grip 3 is provided at the proximal end of the sheath 2. The operation unit 4 is provided with an operation lever (higane) 5. The operation lever 5 is pivotally attached to the middle portion of the operation lever 5 above the grip 3 by a connection pin 6 so as to be rotatable. The operation lever 5 has an end portion adjacent to the grip 3 at a finger hook portion 7.
An operation of rotating the operation lever 5 with the finger of the hand gripping the grip 3 is performed on the finger holding unit 7. The other end of the operating lever 5 is provided with a joint 9 for connecting the proximal end of an operating rod 8 as a transmitting member inserted into the sheath 2. By rotating the operation lever 5, the operation of moving the operation rod 8 with respect to the sheath 2 can be performed.

On the other hand, a distal tip 11 is fixedly attached to the distal end of the sheath 2. The distal tip 11 has a pair of scissors (pieces) 12a, 1
A treatment section 13 including 2b is provided. Each scissors 1
2a and 12b are pivotally attached to the tip chip 11. The distal ends of the operating rods 8 are connected to the base arms of the pair of scissors 12a and 12b via an opening / closing link mechanism (not shown). And a pair of scissors 12a, 12b
Is closed by pulling the operation rod 8, and is opened by pushing the operation rod 8 in reverse.

The operating rod 8 is, as shown in FIG.
The operation rod 8 is configured as follows. That is, the operating rod 8 is a hard core (shaft) made of metal.
15 is an inner layer, and the outer peripheral surface of the core 15 is covered with an outer layer 16 made of resin over at least the entire region located in the sheath 2. The outer layer 16 is formed by melting and extruding the material.

At least the sheath 2 is provided on the outer surface of the outer layer 16.
As shown in FIGS. 3 and 4 over the entire region located inside, a plurality of minute projections 18 and depressions 19 are formed in a form that enhances the slidability with the sheath 2. The convex portions 18 here are formed in a triangular pyramid-shaped mountain shape as shown in FIG. 4, and the vertices of the convex portions 18 are respectively arranged at intersections of a plurality of obliquely imaginary lines as shown in FIG. 3. In other words, the so-called obliquely arranged arrangement is evenly distributed. The portion in which the minute convex portions 18 and concave portions 19 are formed is the outer layer 1.
It is not limited to the case where it is formed over the entirety of the sheath 6, but may be formed only in a part of the region according to the degree of the need to enhance the slidability with the sheath 2.

The average value (roughness) of the difference between the heights of the convex portions 18 and the concave portions 19 is 5 μm, and the density of the convex portions 18 is 1 m.
On average, about 1,000 convex portions 18 are formed per m square. Further, the projections 18 are not limited to being arranged in a regular positional relationship, but may be arranged in an irregular positional relationship to some extent.

The height of the unevenness is 5 microns, but if the value is between 1 and 15 microns, good sliding is exhibited, and more preferably, the value between 3 and 5 microns. A stable high slip property can be obtained.

On the other hand, if the height of the irregularities is less than 1 micron, the irregularities are made of resin when they come into contact with the inner surface of the sheath 2, so that the irregularities are crushed and the sliding effect is reduced. Further, when the operation rod 8 is larger than this, when a large force is applied to the operation rod 8 in a direction perpendicular to the center axis thereof, the operation rod 8 is easily broken starting from the concave portion 19, In the case where the inner surface of the sheath 2 has a rough surface, the protrusions 18 are caught on the inner surface of the sheath 2 and thus are less slippery.

Here, the outer layer 16 is formed to have a thickness of 50 microns from the top of the projection.
However, the film thickness does not need to be particularly uniform.

The material for forming the outer layer 16 is mainly composed of a resin having some flexibility, for example, polyethylene, polypropylene, polyester such as polyethylene terephthalate and polybutyl terephthalate, polyamide, polyacetal, and vinyl chloride. And
Fluorine resins such as polytetrafluoroethylene, tetrafluoroethylene / hexafluoropropylene copolymer, tetrafluoroethylene / verfluoroalkylvinyl ether copolymer, ethylene / tetrafluoroethylene copolymer, and mixed materials thereof are considered. Can be

Here, the resin material to be coated may be any resin as long as it is a resin, but in particular, the above-mentioned resins are easily available and have high productivity. More preferably, polyethylene, polypropylene, and polyamide are inexpensive and exhibit high slipperiness. When heat resistance is required, fluorine resins such as polytetrafluoroethylene, tetrafluoroethylene / hexafluoropropylene copolymer, tetrafluoroethylene / verfluoroalkylvinyl ether copolymer, and ethylene / tetrafluoroethylene copolymer are used. preferable.

The outer layer 16 is coated on the outer periphery of the core 15 by extrusion, and the projections 18 and the depressions 19 are formed in a predetermined form at the time of molding by adjusting the temperature at the time of molding. The formation method is not limited, for example, after forming a rough coating by blasting or the like after applying a smooth coating. However, in consideration of productivity, the forming method of the present embodiment is preferable.

(Operation) Since the operating rod 8 is covered with an outer layer 16 made of resin having fine irregularities formed on the outer surface thereof, it comes into contact with the inner surface of the hard tubular sheath 2 by the convex portion 18. , The frictional resistance between the operating rod 8 and the sheath 2 is reduced, and the operating rod 8 can be moved and moved back and forth with a light force.

(Effect) Since the operating rod 8 can be moved forward and backward with respect to the sheath 2, the scissors 12a and 12b of the treatment section 13 at the distal end of the sheath 2 can be opened and closed lightly. In addition, since the force applied to the operation rod 8 by the operation lever 5 in the operation unit 3 is not attenuated and efficiently and immediately transmitted to the treatment unit 13 at the distal end, the incision by the scissors 12a and 12b is appropriately performed in response to the hand operation. I can do it.

Second Embodiment A biopsy forceps according to a second embodiment of the present invention will be described with reference to FIG. 5, FIG. 6, FIG. 7, and FIG.

(Structure) FIG. 5 shows the incision forceps 2 for the surgical operation.
1, the surgical incision forceps 21 has a tightly wound coil sheath 22 and is an insertion portion for introducing the coil sheath 22 into a body cavity. An operation unit 23 is provided at the base end of the coil sheath 22.
Is provided with a biopsy treatment section 24 at the tip thereof. The operation unit 23 has an operation unit main body 25 and an operation slider 26, and the operation slider 26 is connected to an operation wire 27 inserted through the lumen of the coil sheath 22. The biopsy treatment section 24 has a pair of openable and closable biopsy cups 24a and 24b. The pair of biopsy cups 24a and 24b opens and closes in conjunction with the pushing and pulling operation of the operation wire 27.

The operation wire 27 is formed of, for example, a single wire made of stainless steel. As shown in FIG. 6, an outer layer 1 made of resin is provided on the outer peripheral surface of the operation wire 27.
7 are coated. The operation wire 27 is movably inserted into the lumen of the coil sheath 22.

As shown in FIGS. 7 and 8, a large number of minute projections 28 and depressions 29 are formed on substantially the entire outer surface of the outer layer 17 covered with the operation wire 27.
Each convex portion 28 is formed in a streak shape in parallel at equal intervals, and the streak of the convex portion 28 is formed spirally with respect to the outer peripheral surface of the operation wire 27 as a whole. As shown in FIG. 8, the cross-sectional shape of the convex portion 28 is semicircular, and the bottom surface of the concave portion 29 is formed flat.

Further, unlike the first embodiment, the height difference between the projections 28 and the recesses 29 is about 10 μm on average, and the thickness of the outer layer 17 is 5 μm, which is uniform. As described above, fine irregularities are formed on the surface of the outer layer 17 in such a manner as to enhance the slidability with the coil sheath 22.

The outer layer 17 in the present embodiment does not need to electrically insulate the operation wire 27 as in the first embodiment.
0, that is, a portion where the member of the operation wire 27 is partially exposed on the surface.

As the resin material for forming the outer layer 17, the same resin as in the first embodiment is used.

(Operation) This is the same as the first embodiment.

(Effect) In addition to the effect of the first embodiment, the fine concave portion 29 has a surface on which dirt is unlikely to adhere due to the formation of streaks. In addition, since the streaks of the concavo-convex portions are formed in a spiral shape, a function of high slipperiness in the axial direction is achieved.

[Third Embodiment] A third embodiment of the present invention will be described with reference to FIG. This embodiment is a modification of the above-described second embodiment.

(Configuration) In the present embodiment, the outer layer 17 is not formed on the operation wire 27. Instead,
An inner layer 31 is formed on the inner surface of the coil sheath 22. The inner layer 31 is made of the same resin material as that of the above-described embodiment, and the inner surface of the inner layer 31 has the same minute unevenness as that of the second embodiment. Other configurations are the same as in the second embodiment.

(Operation) This is the same as the first embodiment.

(Effect) In addition to the effect of the second embodiment, since the gap between the strands of the coil sheath 22 in which the inner layer 31 is closely wound is filled, the possibility that dirt remains in the gap is reduced, and the inside of the coil sheath 22 is reduced. Cleaning becomes easy.

[Fourth Embodiment] A fourth embodiment of the present invention will be described with reference to FIG. This embodiment is another modification of the above-described second embodiment.

(Configuration) Also in this embodiment, the outer layer 17 is not formed on the operation wire 27. Instead,
The operation wire 27 is inserted through the inner cavity of the coil sheath 22 and is covered with a flexible resin tube 35. The operation wire 27 forms a gap with the inner surface of the tube 35 and is housed in the tube 35.

The inner and outer surfaces of the tube 35 are provided with the second
The minute unevenness similar to the embodiment is formed. Other configurations are the same as in the second embodiment.

(Operation) This is the same as the first embodiment.

(Effect) In addition to the effect of the second embodiment, since the operation wire 27 is housed in the tube 35, the operation wire 27 is hardly buckled.

Fifth Embodiment A bipolar high-frequency incision forceps for an endoscope according to a fifth embodiment of the present invention will be described with reference to FIGS.

(Structure) FIG. 11 shows a bipolar high-frequency incision forceps 41 for an endoscope. The high-frequency incision forceps 41 includes a sheath 42 made of a flexible resin tube. There is an insertion section to be introduced into.
The material of the sheath 42 is formed of a flexible resin such as polytetrafluoroethylene or polyethylene.

Two twisted stainless steel wires 43 having flexibility are inserted through the inner lumen of the sheath 42. These stainless wires 43 have the operation section 4 at the base end.
4 and an operation wire connected to the slider 45. These stainless wires 43 are connected to a high-frequency terminal 47 provided on the slider 45. The slider 45 is slidable back and forth along the operation section main body 46.

An outer layer 48 made of the same resin material as in the first embodiment is formed on the outer peripheral surface of the stainless steel wire 43. The outer layer 48 has minute irregularities formed on the surface thereof as in the first embodiment.

The distal end portion of the stainless wire 43 is disposed so as to be able to protrude and retract from the distal end of the sheath 42, and the distal ends of the two stainless steel wires 43 are connected by a tip 49.
Then, as shown in FIG. 11, a loop-shaped loop portion 50 is formed at the tip end portion connected by the tip 49. The loop portion 50 is habitually formed so as to spread in a ring shape when protruding from the distal end of the sheath 42. Further, the outer layer 48 is formed at least on the outer periphery of a region inserted into the sheath 42 except for a portion forming the loop portion 50 of the stainless wire 43.

(Operation) The operation wire 46 has an outer layer 48 on the outer surface of the twisted stainless steel wire 43, so that the stainless steel wire 43 keeps a structure in which the stainless steel wire 43 is not easily frayed.
Further, when a high frequency is applied to the stainless steel wire 43, the outer layer 48 improves electrical insulation.

(Effects) In addition to the effects of the first embodiment, the electrical insulation in the sheath 42 is improved, and the medical staff does not have to worry about a leakage accident while using the present treatment tool.

The present invention is not limited to the embodiment described above. According to the description of the above embodiment, at least the following items and items obtained by arbitrarily combining them can be obtained.

<Supplementary Notes> A long sheath, a treatment section disposed at the distal end of the sheath, an operation section disposed at the proximal side of the sheath, and a treatment drive force that is inserted into the sheath and transmitted from the operation section to the treatment section. In a medical device having a transmitting member, at least a part of an outer surface of the transmitting member is coated with a resin outer layer, and at least a part of an outer surface of the outer layer is slidable with the sheath. A medical device characterized by forming minute irregularities.

2. 2. The medical device according to claim 1, wherein the transmission member is a flexible metal wire, and the sheath is a coil.

3. 2. The medical device according to claim 1, wherein the head of the fine irregularities has a value of 1 to 15 microns on average, preferably 3 to 5 microns.

4. In the medical instruments of the first, second, and third paragraphs,
A medical device, wherein the minute unevenness is formed by a large number of grooves.

5. The medical device according to any one of Items 1, 2, 3, and 4, wherein the resin coating is made of polyethylene, polypropylene,
At least one of polyamide, polyester, polyacetal, vinyl chloride, polytetrafluoroethylene, tetrafluoroethylene / hexafluoropropylene copolymer, tetrafluoroethylene / verfluoroalkylvinyl ether copolymer, ethylene / tetrafluoroethylene copolymer A medical device characterized by being formed of a material containing one type.

6. The medical device according to any one of Items 1, 2, 3, 4, and 5, wherein the method of forming the resin coating and the unevenness is extrusion molding.

7. 9. The medical device according to any one of Items 1, 2, 3, 4, 5, and 6, wherein the metal wire is energized to perform an electrical treatment, and the resin coating covers at least the metal wire. A medical device, wherein the covering portion is electrically insulated.

[0059]

As described above, according to the present invention, the transmitting member, which is inserted into the sheath and transmits the treatment driving force to the treatment section, advances and retreats with a small amount of power in the sheath, so that it is provided from the operation section. The force is sufficiently transmitted to the forceps driving section at the tip, and effective treatment can be performed lightly.

[Brief description of the drawings]

FIG. 1 is a side view schematically showing the entire scissors forceps for a surgical operation according to a first embodiment.

FIG. 2 is an enlarged longitudinal sectional view showing a portion A of an insertion portion of the scissors forceps.

FIG. 3 is an enlarged surface view showing a surface portion of an outer layer covering the outer periphery of the operating rod in the scissors forceps.

FIG. 4 is a cross-sectional view of an operating rod in the scissors forceps and an outer layer covering the operating rod.

FIG. 5 is a side view schematically showing the entire endoscope biopsy forceps according to the second embodiment.

FIG. 6 is a longitudinal sectional view of a portion B of a coil sheath of the endoscope biopsy forceps.

FIG. 7 is an enlarged surface view showing a surface portion of an outer layer covering the outer periphery of the operation wire in the biopsy forceps for an endoscope.

FIG. 8 is a cross-sectional view of an operation wire and an outer layer covering the operation wire in the biopsy forceps for an endoscope.

FIG. 9 is a longitudinal sectional view of a coil sheath portion of a modified example of the endoscope biopsy forceps according to the second embodiment.

FIG. 10 is a longitudinal sectional view of a coil sheath portion of another modified example of the endoscope biopsy forceps according to the second embodiment.

FIG. 11 is a side view schematically showing the whole of a bipolar high-frequency incision forceps for an endoscope according to a fifth embodiment.

FIG. 12 shows the bipolar high-frequency incision forceps for an endoscope.
Sectional drawing which expanded the C part shown by.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Dissection forceps for surgical operation 2 ... Sheath 4 ... Operation part 5 ... Operation lever 8 ... Operation rod 13 ... Treatment part 15 ... Core (shaft) 16 ... Outer layer 18 ... Convex part 19 ... Concave part

Claims (3)

[Claims] 1. A long sheath, a treatment section disposed at a distal end of the sheath, an operation section disposed at a hand side of the sheath, and a treatment section inserted into the sheath and from the operation section. A transmission member for transmitting a treatment driving force, wherein at least a part of an outer surface of the transmission member is covered with a resin outer layer, and at least a part of an outer surface of the outer layer slides with the sheath. A medical device characterized in that minute irregularities are formed in a form that enhances performance. 2. The medical device according to claim 1, wherein the transmitting member is a flexible metal wire, and the sheath is a coil. 3. The medical device according to claim 1, wherein the small irregularities have an average drop of 1 μm to 15 μm.
A medical device characterized by being between microns.