JP2001327510A - Scattering treatment tool for endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a scattering treatment tool for an endoscope capable of unnecessitating re-focusing by avoiding losing sight of a lesion site during operation for putting the treatment tool out of and into an endoscope channel in the case of observation or treatment by using the endoscope. SOLUTION: This tool is provided with a tip constitution body 38 for scattering fluid 38 at the tip of one duct of a flexible sheath 21 having at least two ducts formed inside. Fluid is supplied to the body 38 through the one duct to scatter the fluid and the treating tool can be put out and in through the other duct.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscope spraying instrument used in conjunction with an endoscope.

[0002]

2. Description of the Related Art When treating a lesion in a body cavity using an endoscope, a pigment such as indigo carmine or crystal violet is sprayed onto the lesion using a spray tube. Work has been performed to clarify the periphery of a lesion and specify the size of the lesion.
This type of spray tube is disclosed in, for example, Japanese Utility Model Laid-Open No. 3-56451.
No. 6,098,045.

Further, in recent years, so-called magnifying endoscopes capable of enlarging and observing an observation site have been developed and used, and the morphology (pit pattern) of a mucosal surface layer of a lesion site where a pigment or the like is sprayed has been developed. )
It has become possible to determine whether a lesion is benign or malignant on an endoscopic image, and it has become increasingly important to apply a dye to a lesion site.

[0004] By the way, various works and treatments are performed even after observing the lesion mucosa. The following shows examples of typical operations and treatments performed after the application of the dye.

[0005] First, when the lesion mucosa is prominent, the protruding lesion site is tied up with a metal snare wire, a high-frequency current is applied to the metal snare wire, and the protruding lesion site is cauterized and cut off.

On the other hand, when the lesion mucosa is flat, first, a fluid such as physiological saline is injected under the mucosa with an injection needle.
The affected mucosa is bulged. Next, the swollen lesion site is tied up with a metal snare wire, and a high-frequency current is applied to the metal snare wire to cauterize and cut the lesion site.

[0007] Further, after the excision operation, the excision position may be marked in advance with a knife wire to which a high-frequency current has been applied after the dye has been sprayed, so that it can be confirmed that the lesion mucosa has been reliably excised.

[0008] In addition, even if the mucous membrane after the application of the dye is observed in a magnified manner, if it cannot be surely diagnosed as a malignant lesion, a biopsy is performed to analyze the tissue to obtain a definitive diagnosis. Sometimes.

Further, before the treatment of the lesion, the size of the lesion may be measured in advance using a measuring instrument or the like.

[0010] As described above, following the operation of clarifying a lesion by a dye spraying operation using a spray tube, the operation is shifted to various operations and treatments. That is, after the dye spraying operation using the spray tube, the spray tube is once pulled out from the endoscope channel, and a treatment tool suitable for the next operation or treatment is inserted into the endoscope channel.

As described above, after the dye spraying operation using the spray tube, the lesion mucosa is observed, the spray tube is pulled out from the endoscope channel, and the treatment tool suitable for the next treatment is again inserted into the endoscope. Since the procedure is to insert the endoscope into the channel, by inserting and removing the treatment tool from the endoscope channel, the lesion part captured in the field of view is lost or becomes out of focus. Have to operate and focus.

In particular, when observation is performed using a magnifying endoscope, the observation depth of the magnifying endoscope is very short, 2 to 3 mm.
Since the viewing angle is as narrow as 35 degrees, it is difficult to position and focus on a lesion site as compared with a normal endoscope, and there is a drawback that the procedure takes time.

[0013] Moreover, since the portion targeted by the magnifying endoscope is often a small lesion of about 5 mm, the lesion is often lost when the treatment instrument is inserted into or removed from the endoscope channel.

As a result, there has been a problem that the treatment time becomes longer and the burden on the patient increases.

An object of the present invention is to solve the above-mentioned problems associated with the operation of inserting and removing a treatment instrument into and from a conventional endoscope channel in the operation and treatment performed after the dye spraying operation.

That is, an object of the present invention is to perform focusing and re-focusing while observing or treating using an endoscope without losing a lesion site during insertion / removal of a treatment tool to / from an endoscope channel. It is an object of the present invention to provide a spraying instrument for an endoscope which can eliminate the necessity of performing the spraying.

[0017]

According to a first aspect of the present invention, there is provided a flexible sheath, a first conduit provided inside the sheath, and a first conduit provided at a distal end of the first conduit. A fluid supply unit provided on the proximal side of the sheath and supplying fluid to the first conduit, and a second treatment conduit provided inside the sheath And a spraying treatment tool for an endoscope.

According to a second aspect of the present invention, in the spraying treatment instrument for an endoscope according to the first aspect of the invention, the treatment instrument is inserted through the second conduit from a hand side. It is assumed that.

According to a third aspect of the present invention, there is provided the endoscope spraying treatment tool according to the first aspect of the present invention, wherein the second conduit includes a treatment tool provided at a distal end of a sheath and a hand side. And a connecting means for connecting to the operating section.

By using the treatment tool for an endoscope of the present invention, the operation and treatment subsequent to the dye spraying operation can be continued without having to insert and remove the endoscope channel. It is possible to aim at reduction of the work efficiency.

[0021]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS [First Embodiment] FIG. 1 is an external view of an enlarged endoscope in a state in which a spraying instrument for an endoscope is inserted into an endoscope channel.

As shown in FIG. 1, the magnifying endoscope 1 is provided with an operation section 2 located at a hand side and an insertion section 3 formed by a flexible tube connected to the operation section 2. . The distal end component 5 is connected to the insertion portion 3 via a bending portion 4 that can be bent. The operation unit 2 is provided with a forceps insertion base 10 together with a bending knob 6, an air / water supply button 7, a suction button 8, and an eyepiece 9.

One end of an unillustrated endoscope channel (also referred to as a treatment instrument channel; hereinafter, referred to as a treatment instrument channel) installed in the magnifying endoscope 1 is connected to the forceps insertion mouthpiece portion 10. The other end of the treatment instrument channel is connected to a forceps port 11 formed in the distal end component 5.

The dispersing treatment tool 20 for an endoscope has a sheath 21 that is inserted from the forceps insertion mouthpiece portion 10 of the magnifying endoscope 1 into the treatment tool channel. The sheath 21 is, for example, a flexible tube made of a polymer resin such as polytetrafluoroethylene, tetrafluoroethylene-perfluoroalkylvinyl ether copolymer, or tetrafluoroethylene-hexafluoropropylene copolymer. It is flexible and long enough to penetrate and penetrate the channel.

The sheath 21 may have a plurality of conduits. Further, regarding the conduit, the cross section is not limited to a circle, and may have a crescent-shaped cross section. Also, there is no limitation on the cross-sectional size of the pipeline,
The sizes of the plurality of conduits may be different.

An endoscope spraying instrument 20 according to the present embodiment.
Then, two conduits 2 as shown in FIG.
2a and 22b are formed. Hereinafter, the spraying instrument for endoscope 20 will be described in detail.

As shown in detail in FIG. 3, a treatment tool operation section main body 23 is fixed to the proximal end of the sheath 21 of the endoscope spraying treatment tool 20 by a method such as adhesion or press fitting. Inside the treatment instrument operation unit main body 23, holes 24a and 24b respectively communicating with the two conduits 22a and 22b of the sheath 21 are provided.

An injection needle operating portion 25 of the injection device is slidably fitted into and attached to one hole 24a of the treatment instrument operating portion main body 23. A flexible tube 26 forming a passage for supplying a fluid such as a physiological saline is provided in the injection needle operating section 25.
Is attached. The injection needle operation unit 25 constitutes a working unit for operating an injection device when performing an endoscopic injection into a body cavity.

The flexible tube 26 of the injection device is made of a polymer resin such as, for example, polytetrafluoroethylene, tetrafluoroethylene-perfluoroalkylvinyl ether copolymer, or tetrafluoroethylene-hexafluoropropylene copolymer. .

The flexible tube 26 is slidably inserted from the hole 24 a of the treatment instrument operating section main body 23 to the conduit 22 a of the sheath 21. Further, a first base 27 is provided at the base end of the injection needle operating section 23, and a syringe (not shown) for injecting a fluid such as a physiological saline is attached to the first base 27.

A second base 28 is protruded from an upper portion of the treatment instrument operating section main body 23 on the side thereof. The second mouthpiece 28 communicates with the hole 24b of the treatment instrument operation unit main body 23, and the second mouthpiece 28 forms a fluid supply unit to which a syringe (not shown) for injecting a fluid such as a dye is attached.

Next, the configuration of the distal end portion of the endoscope spraying instrument 20 will be described. A flexible tube 26 of the injection device is arranged in one conduit 22a of the sheath 21. The distal end of this tube 26 has a fluid injection needle 31
Is fixed by a method such as press-fitting or bonding. Therefore, when the injection needle operation unit 25 is moved forward and backward, the fluid injection needle 31 moves forward and backward via the tube 26, and protrudes and retracts from the distal end of the sheath 21.

A tip end stopper 32 of a pipe-shaped fluid injection needle is fixed in the distal end portion of the conduit 21a of the sheath 21 by a method such as press fitting or bonding.

When the distal end of the tube 26 abuts against the distal end stopper 32 of the fluid injection needle, the projection length of the fluid injection needle 31 is regulated, and the projection length of the fluid injection needle 31 is always kept constant. I have. By retracting the tube 26, the projecting tip of the fluid injection needle 31 is
Can be drawn into the fluid injection needle tip stopper 32 from the tip of the needle.

The proximal end of the screw holding tube 36 is fixed to the distal end of the other conduit 22b of the sheath 21 by a method such as press fitting or bonding. At the distal end of the screw holding tube 36, a cylindrical distal end structure 38 containing a screw body 37 is attached. Tip structure 3
A fluid ejection hole 39 is provided at the tip of 8. The distal end component 38 constitutes a fluid spraying portion for spraying a fluid from the fluid ejection hole 39.

The screw body 3 is provided inside the tip structure 38.
7 are provided concentrically and closely fitted. A spiral groove 41 is formed on the peripheral surface of the screw body 37, and the peripheral surface of the screw body 37 is covered by a tip structure 38 provided with a screw holding pipe 36 and a fluid ejection hole 39. Then, the fluid to be sprayed turns when flowing through the spiral groove 41 of the screw body 37 and is ejected in a mist form from the fluid ejection hole 39.

The screw member 37 is provided with a tip member 38.
Although it may be fixed inside, it may be installed with a clearance for rotating and moving in the axial direction in the distal end structure 38.

Further, in order to increase the fixing strength between the tip end stopper 32 of the fluid injection needle fixed to the sheath 21 and the screw holding tube 36, a pipe 42 is put on the outer periphery of the sheath 21 as shown in FIG. The two ends of 42 may be caulked. Pipe 4 on the outer periphery of sheath 21
The method of crimping over 2 is also applicable to a sheath having a single conduit.

By increasing the strength of the sheath 21 at the proximal side rather than the distal end, buckling of the sheath 21 at the proximal side is prevented, and the insertability of the endoscope 1 into the treatment instrument channel is improved. It can be further improved. FIG. 5 shows an example of this, which is the operation unit main body 23.
The outer sheath 45 is put on the outer periphery of the sheath 21 from the end toward the distal end of the sheath 21, and the distal end portion of the outer sheath 45 is
It is a method of fixing to 1. As a method of fixing the outer sheath 45 to the sheath 21, there are a method of fixing with an adhesive, a method of fixing with a heat shrinkable tube 46, and the like.

Such a stopping method is not limited to a sheath having a plurality of conduits, but can be applied to a sheath having a single conduit.

The distal end of the sheath 21 of the endoscope spraying instrument 20 needs to have flexibility so that the curved portion 4 of the endoscope 1 can easily pass therethrough.
In order to make the sheath 21 flexible, as shown in FIG. 6, a process 47 is applied to the side surface of the conduit 22a of the sheath 21. As shown in FIG.
1 and the sheath 21 is set in
There is a method of making a cut in the direction B and the direction B to cut out the side wall. The number of the side surface processing 47 is not limited to one, but may be any number in the sheath 21.

Next, the spraying treatment instrument 20 for an endoscope having the above configuration
The operation when using is described. The forceps insertion base 10 of the magnifying endoscope 1 in which the insertion section 3 has been previously inserted into the body cavity.
The sheath 21 of the endoscope spraying instrument 20 is inserted,
The distal end portion of the sheath 21 is protruded from the distal end component 5 through the channel in the insertion section 3 and the bending section 4 of the endoscope 1.

Next, the magnifying endoscope 1 is operated to focus on the surface layer of the mucous membrane and perform magnified observation. At this time, when the lesion is a blind spot in a tissue such as a meniscus fold in the digestive tract and it is difficult to view the lesion in front, the distal end structure 38 of the endoscope spraying instrument 20 is The lesion is pressed against the vicinity of the lesion, and air is sent and sucked, and a tissue such as a fold is put on the lesion while the lesion is viewed from the front.

Then, a syringe filled with a fluid such as a dye is connected to the second base 28 of the treatment instrument operating section main body 23 to inject a fluid such as a dye. The liquid, such as a dye, injected from the syringe passes through the hole 22b in the treatment tool operation unit main body 23, passes through the conduit 22b in the sheath 21 from the second base 28, and passes through the screw holding tube 36 to the small surface of the screw body 37 from the screw holding tube 36. The gas is sprayed so as to flow through the groove 41, pass through the groove 41, and spread forward from the ejection holes 39 of the distal end structure 38.

After observing the lesion, the injection needle operating section 2
5 is pushed forward, and the fluid injection needle 31 is protruded from the distal end portion of the sheath 21. The fluid injection needle 31 protruding from the distal end of the sheath 21 is punctured into the mucous membrane.

Thereafter, the first base 27 of the injection needle operation section 25
Then, a syringe filled with saline or the like is attached thereto, and physiological saline or the like is injected under the mucous membrane to elevate the lesion site.

As can be seen from the above description, the magnifying endoscope 1
In the case of magnifying observation using, it is not necessary to take out and put in the dispersing treatment tool 20 and the syringe, so that there is no need to perform the operation of positioning the magnifying endoscope 1 to the target lesion site or the operation of focusing, or to reduce the time Can be achieved. In addition, since the work of inserting and removing the treatment tool from the treatment tool channel can be omitted,
Work can be simplified over the entire treatment time. This reduces the burden on the surgeon and the patient.

[Second Embodiment] As shown in FIG. 8, the treatment tool for an endoscope according to the present embodiment has a sheath 21 made of two conduits 22a and 22b, as in the first embodiment.
A tubular distal end member 38 is directly press-fitted into the distal end portion of one of the conduits 22b and fixed by a method such as crimping or bonding. A jet nozzle hole 61 is formed at the tip of the tip component 38.

Further, the snare 62 is attached by being inserted into the other conduit 22a of the sheath 21. That is,
An operation wire 63 of a snare 62 is inserted into and provided in one conduit 22a of the sheath 21, a metal snare 62 is provided at the tip of the operation wire 63, and a slider 64 is connected to a rear end of the operation wire 63. did. By moving the slider 64 back and forth, the snare 62 can be moved forward and backward.

The slider 64 is used for the treatment instrument operation section main body 23.
It is movable on a guide 66 attached to the camera. The slider 64 is provided with a plug 67 for connecting a high-frequency power supply, and the plug 67 allows a high-frequency current to flow to the snare 62 at the distal end through the operation wire 63.

A base 28 is provided on the side of the treatment instrument operation section main body 23 in the same manner as in the first embodiment described above. The mouthpiece 28 communicates with the conduit 22b of the sheath 21 via a hole 24b of the treatment instrument operation unit main body 23. A syringe (not shown) for injecting a fluid such as a dye can be attached to the base 28.

In the case of using the treatment tool for an endoscope of the present embodiment, similarly to the case of the first embodiment described above, the treatment tool is introduced endoscopically into a body cavity and used.

First, an endoscope is used to focus on the surface layer of the mucous membrane and to perform magnified observation. Then, a syringe filled with a fluid such as a dye is connected to the base 28 of the treatment instrument operation unit main body 23 to inject a fluid such as a dye. The injected liquid such as a dye flows from the base 28 through the hole 24b in the treatment instrument operation unit main body 23 to the conduit 22b in the sheath 21, and is jetted forward from the jet hole 61 of the distal end structure 38. After spraying the fluid on the mucosal surface layer, the protruding lesion is successively tightened by a snare 62 and a high frequency is applied to resect the lesion. Others are the same as those of the first embodiment.

[Third Embodiment] As shown in FIG. 9, a treatment tool for an endoscope according to the present embodiment has a knife wire 68 at the tip of an operation wire 63 instead of the snare 62 in the second embodiment. It is provided.

The treatment tool for an endoscope according to the present embodiment is used similarly to the treatment tool for an endoscope according to the second embodiment, but differs in the following points. That is, after the fluid is sprayed, a high-frequency current is continuously applied to the knife wire 68 to cauterize the mucous membrane at the edge of the lesion, thereby performing marking so that the mucous membrane can be distinguished from normal mucosa. Others are the same as those of the first embodiment described above.

[Fourth Embodiment] As shown in FIG.
The treatment tool for an endoscope according to the present embodiment is provided with a bending-type measure treatment tool 71 inserted into one of the conduits 22a instead of the snare 62 in the second embodiment.

The measuring instrument 71 includes an operation wire 72,
A coil sheath 73 is inserted therethrough, and a distal end cover 74 is attached to the distal end of the coil sheath 73. A pair of support pieces 75 extending forward are integrally formed on the tip cover 74, and a bending-type measure chip 76 is pivotally attached to the tip of the support piece 75 via a first pin 81. A wire jumpsuit 77 is provided at the tip of the operation wire 72.
The second pin 82 is connected to the tip of the wire jumpsuit 77.
One end of a link plate 78 is pivotally connected via the. The other end of the link plate 78 is pivotally connected to the base of the measure chip 76 via a third pin 83. The portions of the wire jumpsuit 77 and the link plate 78 are covered by a tip cover 74. The major tip 76 is usually coaxial and straight over the wire jumpsuit 77 and the operating wire 72, and the operating wire 7
By pulling 2, the major tip 76 can rotate around the first pin 81 and bend. That is, the major tip 76 can be undulated in a straight state and a bent state shown in FIG.

The proximal end of the coil sheath 73 is connected to the treatment instrument operating section main body 23. A guide 85 is connected to the treatment instrument operation unit main body 23, and a slider 86 slides on the guide 85. The proximal end of the operation wire 72 is connected to the slider 86. By moving the slider 86 back and forth, the operation wire 72 is moved forward and backward, and the leading end of the major tip 76 can be operated.

The treatment tool for an endoscope according to the present embodiment is used similarly to the treatment tool for an endoscope according to the above-described embodiment, but differs in the following points. That is, after the fluid is sprayed, the measurement of the size of the lesion site is continuously performed using the measuring tip 76. Measure tip 76 according to the direction and position of the lesion site
Up and down, and an appropriate measurement operation can be performed. Others are the same as those of the above-described embodiment.

[Fifth Embodiment] As shown in FIG.
In the present embodiment, a pair of forceps cups 90 are provided instead of the measure tip 76 of the fourth embodiment.

Each forceps cup 90 has an intermediate portion pivotally attached to the support piece 75 of the distal end cover 74 by a common first pin 91, and one end of another link plate 78 is provided at the base end of each forceps cup 90. It is pivotally connected via a second pin 92. The other end of the link plate 78 is pivotally connected via a third pin 93 to a tip of a wire jumpsuit 77 connected to a tip of the operation wire 72.

The forceps cup 90 is connected to the distal end cover 35 by a first pin 91, and the distal end cover 7
4 is attached to the coil sheath 73, and the end of the coil sheath 73 is attached to the treatment instrument operation unit main body 23.

The treatment tool for an endoscope according to this embodiment is used in the same manner as the treatment tool for an endoscope according to the above-described embodiment, but differs in the following points. That is, after the fluid is sprayed, and after the fluid is sprayed from the mouthpiece 28, the biopsy is continuously performed. Others are the same as the first embodiment described above.

[Sixth Embodiment] As shown in FIG.
The endoscope treatment tool according to the present embodiment includes a first sheath 102 having a single conduit 101, and a distal end component 104 having a jet hole 103 at the distal end of the first sheath 102 is press-fitted. It is fixedly attached by a method such as bonding. At the proximal end of the first sheath 102, a treatment instrument operation unit main body 106 is provided.
Is attached, and the conduit 101 of the first sheath 102 communicates with a base 107 protruding from the side of the treatment instrument operation section main body 106.

A second sheath 108 is slidably provided inside the first sheath 102. Second sheath 1
A fluid injection needle 111 is provided at the tip of 08. A needle operating section 11 is provided at the proximal end of the second sheath 108.
The fluid injection needle 111 is protruded and retracted from the ejection hole 103 of the distal end structure 104 by operating the injection needle operation unit 112.

The treatment instrument operating section main body 106 has a second
An O-ring 114 is provided for keeping the sheath 108 and the conduit 101 watertight. It can be used in the same manner as in the first embodiment described above.

The present invention is not limited to the above embodiments. According to the above description, each item listed in the following supplementary notes and items obtained by arbitrarily combining those items can be obtained.

[Supplementary Notes] A flexible sheath, a first conduit provided inside the sheath, a fluid dispersing portion provided at a distal end of the first conduit, and a A dispensing treatment tool for an endoscope, comprising: a fluid supply unit that supplies a fluid to one conduit; and a second treatment conduit provided inside the sheath.

2. In the spraying treatment tool for an endoscope described in Item 1, a treatment tool is inserted into the second conduit from a hand side.

3. In the endoscope dissemination treatment tool according to the first aspect, the second conduit has a built-in connection means for connecting the treatment tool provided at the distal end of the sheath and the operation unit on the hand side. It is characterized by being performed.

4. A flexible sheath having at least two conduits formed therein, a fluid distribution portion provided at a distal end of the first conduit of the sheath, and a first conduit provided with the fluid distribution portion And a fluid supply unit on the hand side of the device, and supplies fluid to the fluid distribution unit through the first conduit, disperses the fluid by the fluid distribution unit, and performs treatment through the second conduit. A spraying treatment tool for an endoscope, wherein

5. In the endoscope dispersing treatment tool described in the first and fourth aspects, a fluid dispersing portion is provided at a distal end of a first conduit of the sheath, and a squirt provided on the distal end structure. And a hole.

6. In the endoscope dispersing treatment tool described in the first and fourth aspects, a fluid dispersing portion is provided at a distal end of a first conduit of the sheath, and a squirt provided on the distal end structure. And a screw having a helical groove on a peripheral surface of the hole, which is provided in the distal end structure and supplies a vortex flow toward the ejection hole.

7. The endoscopic spraying instrument according to any one of Items 1, 4, 5, and 6, further comprising a working section for performing an endoscopic procedure at a distal end of the second conduit of the sheath, The operation section of the working section is provided at the base end of the pipe line.

8. Item 7 is the endoscope dispersing treatment tool according to Item 7, wherein the working portion is configured to be able to be taken in and out of the first conduit of the sheath.

9. In the endoscope dispersing treatment instrument described in any one of Items 7 and 8, a flexible second sheath that can be advanced and retracted on the proximal side is provided in the second conduit of the sheath; A fluid injection needle provided at the distal end of the sheath, an operation unit provided at the proximal side of the second sheath, and for causing the fluid injection needle to protrude and retract with respect to the distal end of the sheath; And a second fluid supply unit for supplying fluid to the tip of the fluid injection needle.

10. 7. The endoscope dispersing treatment instrument according to any one of Items 7 and 8, wherein the second conduit has a conductive operation wire which can be advanced and retracted at a hand side, and the sheath which is attached to a distal end of the operation wire. A retractable snare that grips the tissue to be incised at the distal end thereof and pulls the gripped portion to the distal end of the sheath; and an operating unit that is connected to the rear end of the operating wire and pushes and pulls the operating wire to activate the snare. And a high frequency power supply connection plug provided in the operation section, and an inducing means for applying high frequency to the snare from the plug via the operation section member and the operation wire. .

11. In the spraying instrument for an endoscope described in any one of Items 7 and 8, a flexible second sheath inserted through the second conduit and a retractable and retractable inside of the second sheath are provided. An inserted operation wire, a pair of forceps cups provided at a distal end of the second sheath, connected to the operation wire, and for grasping a living tissue at a distal end of the second sheath; An operating unit connected to the rear end of the sheath to push and pull the operation wire to open and close the forceps cup.

12. In the endoscope dispersing treatment instrument described in any one of Items 7 and 8, an operation wire inserted into the second conduit and a living tissue connected to the operation wire at a distal end portion of the sheath are gripped. A pair of forceps cups, and an operation unit connected to the operation wire for opening and closing the forceps cup.

13. 7. The endoscope spraying instrument according to items 7 and 8, wherein the flexible second sheath is inserted into the second conduit and electrically insulated from the outside. A pair of forceps cups provided at the distal end of the second sheath and connected to the operation wire, for picking up living tissue with high frequency; An operation unit connected to the rear end of the sheath for pushing and pulling the operation wire to open and close the forceps cup; a high-frequency power supply connection plug provided in the operation unit; An inducing means for supplying high-frequency power to the forceps cup via a member in the insertion portion is provided.

14. In the endoscope dissemination treatment instrument described in the above paragraphs 7 and 8, the operation wire inserted into the second conduit and the living tissue connected to the operation wire at the distal end of the sheath by high frequency. A pair of forceps cups for sampling, an operation unit connected to the operation wire to open and close the forceps cup, a high-frequency power supply connection plug provided in the operation unit, and members and insertion of the operation unit from the plug An inducing means for energizing the forceps cup with a high frequency through a member in the unit is provided.

15. In the endoscope dispersing treatment tool described in the paragraphs 7 and 8, a conductive operation wire inserted into the second conduit of the sheath so as to be able to advance and retreat, and a knife attached to a distal end of the operation wire. A wire, an operation unit connected to a rear end of the operation wire, for pushing and pulling the operation wire to cause the knife wire to protrude and retract from the distal end of the sheath, and a high-frequency power supply connection provided on the operation unit It is characterized by comprising a plug, and an inducing means for supplying high-frequency current to the knife wire from the plug via the operation member and the operation wire.

16. In the endoscope dispersing treatment tool described in the paragraphs 7 and 8, a flexible second sheath inserted through the second conduit of the sheath, and advanced and retracted into the second sheath. An operation wire freely inserted therethrough, provided at a distal end of the second sheath, connected to the operation wire, and connected to the second wire;
A length measuring tip attached to the distal end of the sheath so as to be bendable, and an operating unit connected to the rear end of the second sheath to push and pull the operation wire to bend the length measuring tip. It is characterized by the following.

17. In the endoscope dispersing treatment instrument described in any one of Items 7 and 8, the operation wire inserted in the second conduit of the sheath so as to be able to advance and retreat by a manual operation, and the sheath is moved by the operation of the operation wire. A length-measuring tip attached to the tip end portion so as to be bendable.

18. In the spraying instrument for an endoscope described in any one of Items 7 and 8, a fluid injection needle provided at a distal end of a second sheath forming a second conduit, and a fluid injection needle provided at a hand side of the second sheath. An operating portion provided at the distal end of the first conduit and capable of operating the fluid injection needle through an ejection hole of a distal end member; And a second fluid supply unit.

[0086]

According to the present invention, the dye dispersing section provided in one of the plurality of conduits in the flexible sheath and the pigment dispersing operation provided in the other conduit are continuously performed. The treatment section capable of performing the operations and treatments to be performed can prevent a small lesion from being lost and a focus shift during magnification observation using a magnifying endoscope. In addition, since the operation of inserting and removing the treatment tool into and from the forceps channel of the endoscope is omitted, the treatment operation can be simplified, and the efficiency of the treatment operation can be improved. As a result, it is possible to reduce the burden on the patient.

[Brief description of the drawings]

FIG. 1 is an external view of an enlarged endoscope in a state where a spraying instrument for an endoscope according to a first embodiment is inserted into a channel.

FIG. 2 is a cross-sectional view of a sheath of the endoscope spraying instrument.

FIG. 3 is a longitudinal sectional view of the spraying instrument for an endoscope.

FIG. 4 is an enlarged longitudinal sectional view of a distal end portion of the endoscope spraying treatment tool.

FIG. 5 is a longitudinal sectional view of a proximal end portion of a sheath of the endoscope spraying instrument.

FIG. 6 is a perspective view of a distal end portion of a sheath of the endoscope spraying instrument.

FIG. 7 is an explanatory view of a processing method applied to a distal end portion of a sheath of the endoscope spraying treatment tool.

FIG. 8 is a cross-sectional view of a spraying treatment tool for an endoscope according to a second embodiment.

FIG. 9 is a cross-sectional view of a spraying instrument for an endoscope according to a third embodiment.

FIG. 10 is a cross-sectional view of a spraying instrument for an endoscope according to a fourth embodiment.

FIG. 11 is a cross-sectional view of a spraying instrument for an endoscope according to a fifth embodiment.

FIG. 12 is a cross-sectional view of a spraying instrument for an endoscope according to a sixth embodiment.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Magnification endoscope, 20 ... Endoscope spraying treatment tool, 21 ... Sheath, 22a, 22b ... Channel, 23 ... Treatment tool operation part main body, 25 ... Injection needle operation part of an injection device, 26 ... Flexible Tube 27, first base 28, second base 31, fluid injection needle 36, screw holding tube 37, screw body,
Reference numeral 38 denotes a tip member, 39 denotes a fluid ejection hole, 41 denotes a spiral groove.

Claims (3)

[Claims] 1. A flexible sheath, a first conduit provided inside the sheath, a fluid dispersing part provided at a tip of the first conduit, and a proximal side of the sheath. An endoscope comprising: a fluid supply unit provided to supply a fluid to the first conduit; and a second treatment conduit provided inside the sheath. Spraying instrument. 2. The spraying treatment tool for an endoscope according to claim 1, wherein a treatment tool is inserted into the second conduit from a hand side. 3. The apparatus according to claim 1, wherein the second conduit includes a connecting means for connecting a treatment tool provided at a distal end of the sheath and an operation unit on a hand side. The spraying instrument for an endoscope according to the above.