JP2002035003A - High-frequency inciser of endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a high-frequency inciser for an endoscope which is capable of incising a biliary outlet into the duodenum in a proper direction along the biliary running direction when passing the inciser into a treatment equipment insertion channel of a duodenum fiber scope and incising the biliary outlet. SOLUTION: The high-frequency inciser for the endoscope is pierced with a pair of holes 12 and 13 apart a spacing in an axial direction at the side wall near a front end of a flexible tube 11 having an electrical insulating characteristic, is arranged with a conductive wire 15 inserted and arranged into the flexible tube 11 in a manner as to allow the energization of high-frequency current between the pair of the holes 12 and 13, and is constituted in such a manner that the flexible tube 11 is bent to a bow form between the pair of the holes 12 and 13 by pulling the conductive wire 15 toward the operator side. The pair of the holes 12 and 13 are disposed in positional relations twisted around the axis of the flexible tube 11.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a high-frequency incision device for an endoscope which is used for incising a Vater's papilla or the like which is an outlet of a biliary tract into the duodenum through a treatment tool insertion channel of the endoscope. About.

[0002]

2. Description of the Related Art Jaundice occurs when gallstones are blocked in the biliary tract,
A technique of excreting such gallstones into the duodenum using an endoscope without performing laparotomy has been performed since about 1980.

[0003] Such an endoscopic procedure is performed by passing a simple high-frequency incision tool consisting of a flexible tube and a conductive wire through a treatment tool insertion channel of a side-viewing duodenal fiberscope.

FIG. 7 shows a distal end portion of a conventional high-frequency incision tool 10. A pair of holes 12, which are spaced apart in the axial direction on a side wall near the distal end of an electrically insulating flexible tube 11.
13, a conductive wire 1 inserted through the flexible tube 11 so as to allow a high-frequency current to flow therethrough.
5 is disposed along the outside of the flexible tube 11 between the pair of holes 12 and 13.

[0005] The distal end of the conductive wire 15 is locked inside the distal end of the flexible tube 11, and the conductive wire 15
Of the flexible tube 11 is bowed between the pair of holes 12 and 13, and a sphincter muscle or the like is cut at a high frequency by the chord-shaped conductive wire 15 at that portion. .

[0006]

As shown in FIG. 5, a treatment tool outlet 2 which is an outlet of a treatment tool insertion channel of a side-view type duodenal fiberscope 1 has an observation window 3.
And the treatment tool protrusion 2 is located on the right side of the observation field of view 100.

[0007] As shown in FIG. 6, a high-frequency incision tool 10 protruding from the treatment tool protruding port 2 has an observation visual field 10.
The treatment tool protrusion 2 is formed to be inclined with respect to the observation optical axis 4 so as to face the center direction of 0.

For this reason, the distal end portion of the high-frequency incision tool 10 protruding from the treatment tool outlet 2 has a bending habit caused by being changed with a small radius of curvature in a passage at the back of the treatment tool outlet 2 and a treatment. As shown in FIG. 5, it is combined with the inclination of the tool projecting port 2 itself and projected into the observation visual field 100 while curving obliquely to the upper left.

FIG. 8 schematically shows a state in which the distal end portion of the conventional high-frequency incision instrument 10 is inserted into the biliary tract 201 from the duodenal fiberscope 1 inserted into the duodenum 200.

In this state, when the conductive wire 15 is pulled toward the hand while a high-frequency current is applied to the conductive wire 15, a string is formed between the pair of holes 12, 13 as shown in FIG. The incision 202 of the sphincter incised by the conductive wire 15 tends to gradually shift to the left,
The incision damage is unnecessarily large.

Accordingly, the present invention provides an endoscope capable of performing an incision in a desired direction along the running direction of the biliary tract when incising the outlet of the biliary tract into the duodenum through a treatment instrument insertion channel of a duodenal fiberscope. An object of the present invention is to provide a high-frequency incision tool.

[0012]

In order to achieve the above-mentioned object, a high-frequency incision instrument for an endoscope according to the present invention is provided on a side wall near the distal end of an electrically insulating flexible tube at an axial distance. A pair of holes are formed, and a conductive wire inserted through the flexible tube so as to allow a high-frequency current to flow is disposed along the outside of the flexible tube between the pair of holes, and the conductive wire In a high-frequency incision device of an endoscope in which the flexible tube is bent in a bow shape between the pair of holes by pulling the pair toward the hand, the pair of holes are twisted around the axis of the flexible tube. It is provided in a positional relationship.

When the conductive wire exposed between the pair of holes is viewed from the front with the tip of the flexible tube facing upward, the conductive wire is turned clockwise with respect to the axial direction of the flexible tube. It is good to be inclined in the direction.

[0014]

Embodiments of the present invention will be described with reference to the drawings. FIG. 1 shows a high-frequency incision device 10 according to an embodiment of the present invention.
A pair of holes 12 and 13 are formed in the side wall near the distal end of an electrically insulating flexible tube 11 made of, for example, tetrafluoroethylene resin, at intervals in the axial direction. .

Then, the conductive wire 15 made of, for example, a stranded stainless steel wire inserted through the flexible tube 11 is exposed only between the pair of holes 12 and 13 so as to extend outside the flexible tube 11. It is arranged.

The distal end of the conductive wire 15 is connected to the short tube 1 made of stainless steel and disposed inside the distal end of the flexible tube 11.
4 and brazed. Since this short cylinder 14 cannot pass through the hole 12 near the tip, the conductive wire 1
When the wire 5 is pulled toward the user, the flexible tube 11 is bent in a bow shape between the pair of holes 12 and 13, and the conductive wire 15 becomes a chord at that portion.

An operating portion for moving the conductive wire 15 in the axial direction is attached to the base end of the flexible tube 11, and a terminal for connecting the conductive wire 15 to a high-frequency power source is provided. Located on the operation unit. However,
As such an operation unit, a known operation unit can be used, and the description thereof is omitted.

A pair of holes 12 and 13 are provided in the flexible tube 1.
As shown in FIG. 1, the conductive wire 15 is formed between the pair of holes 12 and 13 with the tip of the flexible tube 11 facing upward. When viewed from the front, the conductive wire 15 is inclined clockwise with respect to the axial direction of the flexible tube 11 (that is, obliquely from the upper right to the lower left).

In this embodiment, a pair of holes 1
2 and 13 are twisted by about 180 ° around the axis of the flexible tube 11, but may be twisted by 90 ° or any other degree.

As shown in FIG. 2, the high-frequency incision instrument 10 is passed through the treatment instrument insertion channel of the duodenal fiber scope 1 and its distal end is inserted into the duodenum 200 into the biliary tract 201. The tip is curved diagonally to the upper left, but a pair of holes 1
The conductive wire 15 exposed between the portions 2 and 13 is set in a direction almost straight with respect to the direction of the biliary tract 201.

Therefore, from this state, the conductive wire 1
When the conductive wire 15 is pulled toward the user while a high-frequency current is applied to the pair 5, as shown in FIG.
The sphincter is incised substantially in the running direction of the biliary tract 201 by the conductive wire 15 in a chord-like shape between the two, 13, and as shown in FIG. It will be straight without any deviation.

The present invention is not limited to the above embodiment. For example, the tip of the conductive wire 15 is not pulled out from the hole 12 near the tip when the conductive wire 15 is pulled from the near side. Any configuration may be adopted as long as it is as described above.

Further, the present invention is not limited to the incision of the sphincter at the outlet of the biliary tract from the inside of the duodenum, and various types of incisions by the conductive wire 15 for inclining the cutting direction with respect to the direction of the distal end of the flexible tube 11 are possible. It can be applied to an endoscopic high-frequency incision tool.

[0024]

According to the high-frequency incision device of the endoscope of the present invention, the pair of holes are provided in a positional relationship twisted around the axis of the flexible tube, thereby being exposed between the pair of holes. The conductive wire can be inclined with respect to the axial direction of the flexible tube, and as a result, when incising the outlet of the biliary tract into the duodenum through the treatment instrument insertion channel of the duodenal fiberscope, A variety of transendoscopic devices that can safely and safely cut straight along the direction of the biliary tract and aim to incline the cutting direction with the conductive wire with respect to the tip of the flexible tube. Useful for high frequency incisions.

[Brief description of the drawings]

FIG. 1 is a partial side sectional view of a distal end portion of a high-frequency incision device of an endoscope according to an embodiment of the present invention.

FIG. 2 is a schematic diagram showing a use state (before incision) of the high-frequency incision tool of the endoscope according to the embodiment of the present invention.

FIG. 3 is a schematic diagram showing a use state (during dissection) of the high-frequency dissection instrument of the endoscope according to the embodiment of the present invention.

FIG. 4 is a schematic diagram illustrating a use state (after dissection) of the high-frequency dissection instrument of the endoscope according to the embodiment of the present invention.

FIG. 5 is a perspective view showing a state in which the distal end of the high-frequency incision tool is projected from the distal end of the duodenal fiber scope.

FIG. 6 is a schematic front sectional view of a distal end portion of a duodenal fiber scope.

FIG. 7 is a partial side sectional view of a distal end portion of a conventional high-frequency incision instrument for an endoscope.

FIG. 8 is a schematic view showing a use state (before incision) of a conventional high-frequency incision device for an endoscope.

FIG. 9 is a schematic diagram showing a use state (during dissection) of a conventional high-frequency dissection instrument for an endoscope.

FIG. 10 is a schematic diagram showing a use state (after dissection) of a conventional high-frequency dissection instrument for an endoscope.

[Explanation of symbols]

 11 Flexible tube 12, 13 hole 15 Conductive wire 202 Incision

Claims (2)

[Claims] 1. A pair of holes are formed in the side wall near the distal end of an electrically insulating flexible tube at intervals in the axial direction, and are inserted through the flexible tube so that a high-frequency current can be supplied. The arranged conductive wire is arranged along the outside of the flexible tube between the pair of holes, and the flexible tube is pulled between the pair of holes by pulling the conductive wire toward the hand. A high-frequency incision device for an endoscope, wherein the pair of holes is provided in a positional relationship twisted around an axis of the flexible tube. Incision tool. 2. When viewed from the front, the conductive wire exposed between the pair of holes with the distal end of the flexible tube facing upward, the conductive wire is in the axial direction of the flexible tube. The high-frequency incision device for an endoscope according to claim 1, wherein the high-frequency incision device is inclined clockwise with respect to.