JP2005204807A - Basket type grasping forceps - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a basket type grasping forceps easily manufacturing a basket part of a type eliminating a tip for easily taking foreign matter such as a calculus in the basket even in a narrow lumen and a constriction part in front thereof. <P>SOLUTION: This basket type grasping forceps is so constituted that the basket part 4 has a plurality of wire sets 6 formed by aligning two elastic wires and fixing them mutually adjacent to the tips, the elastic wires 5 of each set are folded at the tips to form a fold part 8, each fold part 8 is continued to the adjoining elastic wires 5 of the adjoining set, and the fold parts 8 are collected to be formed into the tip part. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to a basket-type grasping forceps, and more particularly to a basket-type grasping forceps that is inserted into a body cavity endoscopically and used to grasp and remove foreign substances such as stones in the body cavity.

  2. Description of the Related Art Conventionally, basket-type grasping forceps are known which are inserted endoscopically into a body cavity and grip foreign substances such as stones generated in a body cavity such as a biliary tract or a bladder. The basket portion of the basket-type grasping forceps disclosed in Japanese Patent Application Laid-Open No. 11-285500 (Patent Document 1) is composed of a plurality of elastic wires, and a plurality of elastic wires are provided so that the plurality of elastic wires swell in a bowl shape. It is the one that is bent. The tips of the plurality of elastic wires are inserted into a short cylindrical tip and fixed by brazing. In order to surely prevent the chip from coming off, brazing is performed so that the elastic wire at the rear end of the chip bulges out. The rear ends of the plurality of elastic wires are connected to an operation wire that is slidably moved back and forth by the operation unit. When a plurality of elastic wires and operation wires are inserted endoscopically into a body cavity, they are inserted into an outer tube fixed to the operation unit.

  In the above-mentioned Japanese Patent Application Laid-Open No. 11-285500 (Patent Document 1), one (set) of a plurality of elastic wires is further fixed to a basket portion made up of a plurality of elastic wires or a middle portion of the wire set. And the form which extended the elastic wire in the front is also shown.

  By the way, in the basket-type grasping forceps as described above, since there is a tip at the tip of the basket portion, a portion protruding forward to some extent is generated by this tip. Moreover, since brazing is performed so that the elastic wire at the rear end of the chip oozes out to prevent the chip from coming off, a hard part due to the oozing of the wax occurs, and when this hard part is added, The protruding part becomes long.

  For this reason, when the foreign matter such as a calculus is taken into the basket portion, the protruding portion described above tends to obstruct the operation of taking the foreign matter such as the calculus into the basket portion, and the foreign matter taking operation is difficult. In particular, in a narrow lumen or a place where the front is blocked, the projecting portion hits the cavity wall, and the basket portion may not be fully opened or stones may not be captured.

In order to avoid such a problem, several basket-type grasping forceps in which the tip is eliminated have been proposed. In Japanese Patent Laid-Open No. 63-317149 (Patent Document 2), one elastic wire is fixed while being passed between twists of the other elastic wire. In USP No. 5989266 (Patent Document 3), a loop is formed in the wire itself at the tip portion, and the loops are fixed to each other by passing them through each other. In Japanese Patent Application Publication No. 2002-537934 (Patent Document 4) and US Pat. No. 6,159,220 (Patent Document 5), a plurality of arranged wires are tied or twisted together to be fixed.
JP 11-285500 A Japanese Patent Laid-Open No. 63-317149 USP 5989266 specification JP 2002-537934 Gazette USP 6159220 specification

  However, there has been a problem in that it is difficult to manufacture the basket portion of the type that eliminates the tip that has been proposed conventionally. That is, in Japanese Patent Application Laid-Open No. 63-317149 (Patent Document 2), a gap is provided between twists of tightly wound thin elastic wires, and the elastic wires are passed therethrough. It was difficult to pass the elastic wire during the twisting of the wire. In USP 5989266 (Patent Document 3), since a small loop is formed in the elastic wire itself, it is difficult to hold the loop. Even if it is possible with a superelastic wire as proposed in Patent Document 3, In general, it is difficult to use a general-purpose elastic wire such as stainless steel, which increases the manufacturing cost. In Japanese translations of PCT publication No. 2002-537934 (patent document 4) and USP 6159220 specification (patent document 5), it takes time to tie wires or twist them together. In addition, the twisted wire will be less straight, and if only the distal tip is twisted and fixed, the size of the twisted part will increase, making it difficult to store in the outer tube. .

  The present invention has been made paying attention to the above-mentioned problems, and the object of the present invention is to eliminate the tip so that foreign substances such as stones can be easily taken into the basket portion even in a narrow lumen or a place where the front is blocked. It is an object of the present invention to provide a basket-type grasping forceps that can more easily manufacture a basket portion of the type described above.

In order to solve the above problems, the basket portion of the basket-type grasping forceps according to the inventions of claim 1 and claim 2 is formed by arranging a plurality of, for example, two elastic wires and fixing them in the vicinity of the tip. Each set of elastic wires is folded at the tip to form a folded portion and is continuous with the adjacent elastic wire of the adjacent set, and the folded portions are gathered to form the tip of the basket portion. It is characterized by forming.
In the basket-type grasping forceps according to the third aspect of the present invention, at least one set of elastic wires of each set is folded back at the base end and is continuous.
In the basket-type grasping forceps according to the fourth aspect of the present invention, all the sets of elastic wires are continuous.
Furthermore, in the basket-type grasping forceps according to the fifth aspect of the present invention, the tip portion of the basket portion has a through hole formed by a space surrounded by the folded portion of the elastic wire.

According to the first and second aspects of the present invention, the basket portion without the tip can be manufactured more easily, and foreign matters such as stones can be easily put into the basket portion even in a narrow lumen or a place where the front is blocked. Can be imported.
According to the invention of claim 3, the number of elastic wire parts can be reduced.
According to the invention of claim 4, it is possible to make one elastic wire part.
Furthermore, according to the invention of claim 5, the guide wire can be inserted into the through hole formed by the space surrounded by the folded portion of the elastic wire at the tip of the basket portion.

(First embodiment)
A first embodiment of the present invention will be described with reference to FIGS. As shown in FIG. 1, the basket-type grasping forceps 1 is made of a resin sheath or the like, and a flexible sheath 2 that can be inserted into a forceps channel of an endoscope, and can freely advance and retreat with respect to the flexible sheath 2. And an operation wire 3 inserted into the operation wire 3 and a gripping basket portion 4 provided at the tip of the operation wire 3.

  The basket portion 4 includes a plurality of, for example, two elastic wires 5 arranged in a row, and a wire set 6 having a fixing portion 7 that is fixed to each other by a fixing agent such as brazing, soldering, or adhesive near the tip. A plurality of sets, for example, four wire sets 6 are provided. One elastic wire 5 in each wire set 6 is continuous with the closest adjacent elastic wire 5 in the wire set 6 adjacent to its own set.

  Moreover, such a basket part 4 is produced as follows. That is, first, as shown in FIG. 3, a single elastic wire as a material is folded at the center to form a folded portion 8 at the middle portion, and both ends of the wire with the folded portion 8 as a boundary are respectively formed. A plurality of elastic wire parts 9 that are elastic wires 5 are prepared. Each elastic wire component 9 includes two elastic wires 5.

  Then, for example, as shown in FIG. 4, four elastic wire parts 9 are used, and the elastic wires 5 of one elastic wire part 9 and the elastic wires 5 of other elastic wire parts 9 adjacent to each other are arranged side by side. Furthermore, in the vicinity of the turn-up portion 8 of each elastic wire component 9, the elastic wires 5 of each wire set 6 are fixed with a fixing agent to form the fixing portion 7. Thereby, the front end side wire part of the basket part 4 is bundled near the front end, and the front end part of the basket part 4 is formed.

  In addition, as shown in FIG. 5, you may form the wire set 6 as the thing in which the elastic wires 5 were continued by alternately folding the several places of the middle of one wire alternately. Also in this case, by fixing the elastic wire 5 of each wire set 6 with a fixing agent, the tip side portion of the basket portion 4 is bound in the vicinity of the tip to form the tip portion of the basket portion 4.

  Next, as shown in FIG. 1, each wire set 6 is bound by the chip 10 at the rear end, and the front ends of the operation wires 3 are also bundled together and fixed.

  Moreover, as shown in FIG. 1, two bending points 11a and 11b are formed in the middle of each wire set 6 in the same manner at intervals from the tip. The bending points 11 a and 11 b are provided at the same positions of the individual elastic wires 5 forming the wire set 6. Furthermore, as shown in FIG. 2, the wire sets 6 are arranged in a three-dimensional line-symmetric relationship with the central axis of the basket portion 4 as the center of symmetry. Thereby, as shown in FIG. 1, the basket portion 4 is formed in a bowl shape as a whole, and the basket portion 4 can freely contract and expand in the central axis direction. By configuring the basket portion 4 in this way, the basket portion 4 having no tip at the tip can be easily manufactured.

  Further, as shown in FIG. 6, an operation unit 12 is provided at the proximal end of the flexible sheath 2. The operation unit 12 includes an operation unit main body 13 fixed to the base end of the flexible sheath 2 and a slider 14 connected to the base end of the operation wire 3 and capable of moving forward and backward with respect to the operation unit main body 13. By moving the slider 14 forward and backward with respect to the operation portion main body 13, the operation wire 3 inserted through the flexible sheath 2 so as to freely advance and retract can be advanced and retracted.

  Next, an operation when the calculus 16 in the gallbladder 15 shown in FIG. 6 is extracted using the basket-type grasping forceps 1 configured as described above will be described.

  First, as shown in FIG. 6, the insertion portion of the endoscope 17 is inserted into the body cavity, and the distal end portion of the insertion portion is positioned near the calculus 16 of the gallbladder 15.

  Next, the slider 14 of the basket-type grasping forceps 1 is pulled toward the hand side, and the flexible sheath 2 is inserted into the channel 18 of the endoscope 17 in a state where the basket portion 4 is housed in the flexible sheath 2. To do. When the flexible sheath 2 protrudes from the distal end of the insertion portion of the endoscope 17, the slider 14 is pushed forward, and the basket portion 4 is protruded from the flexible sheath 2 so as to expand in a bowl shape. In this state, the calculus 16 is taken into the basket portion 4 and the slider 14 is drawn toward the hand side. Then, the shape of the basket portion 4 is reduced. With the calculus 16 taken into the basket portion 4 and held, it is pulled out of the body cavity and the calculus 16 is removed.

  Since there is no chip at the tip of the basket portion 4 of this embodiment, the basket portion 4 can be greatly expanded toward the tip in the gallbladder 15, and the calculus 16 can be easily taken into the basket portion 4.

(Second Embodiment)
7 to 8 show a second embodiment of the present invention. The basket-type grasping forceps 19 of this embodiment has three bending points 11 a, 11 b, 11 c in the middle of each wire set 6. That is, as shown in FIG. 7, a bending point 11a that is bent in the direction of spreading outward is added to the vicinity of the folded portion 8 at the tip. Further, the bending point 11a is located on the tip side of the fixing portion 7 fixed to each other by a fixing agent such as brazing, soldering, or adhesive. By providing the bending point 11a, the basket portion 4 can be expanded more greatly.

  Further, as shown in FIG. 8, the distal end edge portion of the flexible sheath 2 is provided with an enlarged diameter portion 20, and the distal end portion of the basket portion 4 that spreads laterally when contracted by the bending point 11a is enlarged in diameter. It is housed inside the portion 20. The other configuration is the same as that of the first embodiment described above.

  Moreover, although the effect | action of this embodiment is the same as that of 1st Embodiment mentioned above, in addition to the effect of 1st Embodiment mentioned above, there exists an effect that the basket part 4 can be expanded more largely. .

(Third embodiment)
9 to 10 show a third embodiment of the present invention. The basket type grasping forceps 21 of the present embodiment is different from the first embodiment described above in the following parts.

  That is, as shown in FIG. 9, the base end of the elastic wire 5 in each wire set 6 constituting the basket portion 4 extends in the flexible sheath 2 toward the proximal side, and an extended portion of the elastic wire 5 Thus, the operation wire 22 is configured. The elastic wire 5 is bound by a fixing agent 23 at the proximal end of the basket portion 4, and is connected to a rigid operation pipe 24 at the proximal end of the grasping forceps 21. A grip portion 25 is provided at the proximal end of the operation pipe 24. A liquid feed cap 26 is provided at the proximal end of the flexible sheath 2. About another structure, it is the same as 1st Embodiment mentioned above.

  Next, the operation of the basket-type grasping forceps 21 of the present embodiment will be described in the case of collecting bile duct stones.

  First, in a state where the basket portion 4 is housed in the flexible sheath 2, the flexible sheath 2 is introduced into the body cavity through the channel of the endoscope 27 with a side-view type forceps raising base shown in FIG. The distal end of the flexible sheath 2 protrudes from the distal end of the endoscope, and is inserted into the common bile duct 29 from the duodenal papilla 28, for example, as shown in FIG.

  Next, the grip portion 25 in the operation portion 12 is gripped and the operation pipe 24 is pushed in, the basket portion 4 is protruded from the flexible sheath 2, and the basket portion 4 is expanded. Then, as shown in FIG. 10, the calculus 30 is taken into the expanded basket portion 4, the gripping portion 25 is gripped, the operation pipe 24 is pulled, and the basket portion 4 is contracted, so that the basket portion 4 is reduced. Hold the calculus 30 securely.

  Thereafter, the basket-type grasping forceps 21 is pulled out from the body cavity together with the endoscope 27 to collect the calculus.

  Also in the basket-type grasping forceps 21 of the present embodiment, since there is no tip at the tip of the basket portion 4, the same effects as those of the first embodiment described above can be obtained. For example, as shown in FIG. 10, the calculus 30 can be easily taken into the basket portion 4 even in a closed portion such as the hepatic hilar portion 31 upstream of the common bile duct 29. Further, since the elastic wire 5 constitutes the operation wire 22, there is no hard and large-diameter portion through the portion entering the channel of the endoscope 27, so that the insertion into the channel is improved. . Other than that, the same effect as the first embodiment can be obtained.

(Fourth embodiment)
11 to 12 show a fourth embodiment of the present invention. The basket type grasping forceps 32 of this embodiment is different from the third embodiment described above in the following parts.

  That is, at the tip of the basket portion 4, a through hole 33 formed by a space surrounded by the folded portion 8 of the elastic wire 5 is provided. The through hole 33 penetrates into and out of the basket portion 4 and passes through the guide wire 34. It is an internal and external communication hole that can be inserted.

  As shown in FIG. 11A, when the basket portion 4 is stored in the flexible sheath 2, the tip portion forming the through hole 33 protrudes from the tip of the flexible sheath 2. As shown in FIG. 12, the base part 26a of the liquid feeding base 26 is formed to be inclined toward the base end side. Other configurations are the same as those in the third embodiment described above.

  The action of the basket-type grasping forceps 32 of the present embodiment is different from that of the third embodiment described above only in the insertion procedure into the common bile duct 29. That is, the guide wire 34 is introduced into the common bile duct 29 through the endoscope 27 in advance, and the base end of the guide wire 34 is inserted into the flexible sheath 2 from the through hole 33 at the tip of the basket portion 4. Take out from part 26a.

  Then, using this guide wire 34 as a guide, the basket-type grasping forceps 32 is inserted into the common bile duct 29 through the channel of the endoscope 27. Then, the basket part 4 is protruded, the guide wire 34 is pulled out from the basket part 4, and the calculus 30 is taken in.

  The basket-type grasping forceps 32 according to the present embodiment has the same effects as those of the third embodiment described above and can be easily inserted into the common bile duct 29 because the guide wire 34 can be used. .

  In addition, this invention is not restricted to the thing of each embodiment mentioned above. Further, according to the above description, the following items can also be obtained.

(Supplementary note 1) The basket-type grasping forceps according to claim 1, wherein each pair of elastic wires is provided with a plurality of bending points at the same position in the middle part from the distal end to the proximal end. forceps.
(Object of Supplementary Note 1) To provide a basket portion that can stably form and hold a basket shape and is not crushed even in a narrow body cavity.
(Effect of Supplementary Note 1) The basket shape can be stably formed and held, and can be reliably grasped without being crushed even in a narrow body cavity.

(Appendix 2) In the basket-type grasping forceps according to claim 1, each set of elastic wires has a plurality of bending points in the middle portion from the distal end to the proximal end, and branch points branching from each other at intervals. A basket-type grasping forceps characterized by being provided.
(Purpose of Supplementary Note 2) To provide a basket portion in which foreign matter such as captured calculus, particularly small foreign matter is difficult to come off.
(Effect of Supplementary Note 2) The distance between the elastic wires at the front portion of the basket portion becomes close, and foreign matters such as stones are not easily removed from the space.

(Appendix 3) The basket-type grasping forceps according to claim 1, wherein the elastic wire extends into the sheath toward the proximal end to form the operation wire.
(Purpose of Supplementary Note 3) The insertion property of the endoscope into the channel and the insertion property of the guide wire into the sheath can be improved.
(Effect of Supplementary Note 3) Since there is no hard and large-diameter portion on the operation wire, insertability is improved.

It is a longitudinal cross-sectional view near the front-end | tip part of the basket-type grasping forceps which concerns on 1st Embodiment of this invention. It is the front view which looked at the basket part of basket type grasping forceps concerning a 1st embodiment from the front similarly. It is explanatory drawing which shows the manufacture procedure of the basket part of the basket type grasping forceps which similarly concerns on 1st Embodiment. It is explanatory drawing which shows the manufacture procedure of the basket part of the basket type grasping forceps which similarly concerns on 1st Embodiment. It is explanatory drawing which shows the manufacture procedure of the basket part of the other structure of a basket type grasping forceps. It is explanatory drawing in the case of extracting the calculus in a gallbladder similarly using the basket-type grasping forceps which concerns on 1st Embodiment. (A) is a longitudinal cross-sectional view near the tip of the basket-type grasping forceps according to the second embodiment of the present invention, and (B) is a front view of the basket portion of the basket-type grasping forceps as seen from the front. It is. It is a longitudinal section at the time of basket part accommodation near the tip part of basket type grasping forceps concerning a 2nd embodiment similarly. It is a longitudinal section of basket type grasping forceps concerning a 3rd embodiment of the present invention. It is explanatory drawing at the time of extracting the calculus of the hepatic hilar part of a common bile duct upstream using the basket type | mold grasping forceps which concerns on 3rd Embodiment similarly. It is a longitudinal cross-sectional view at the time of basket part accommodation of the tip part vicinity of basket type grasping forceps concerning a 4th embodiment of the present invention. It is a longitudinal section at the time of inserting a guide wire into basket type grasping forceps concerning a 4th embodiment similarly.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Basket-type grasping forceps 2 ... Flexible sheath 3 ... Operation wire 4 ... Basket part 5 ... Elastic wire 6 ... Wire assembly 7 ... Fixed part 9 ... Elastic wire component

Claims (5)

In the basket-type grasping forceps provided with a basket portion that is configured to be able to expand and contract at the tip of the operation wire that is inserted in the sheath so as to be able to advance and retract,
The basket portion has a plurality of sets formed by arranging a plurality of elastic wires and fixing them to each other in the vicinity of the tip, and each set of elastic wires is folded at the tip to form a turn-up portion and adjacent sets. A basket-type grasping forceps characterized by being continuous with the adjacent elastic wires and having the folded-back portions gather to form the tip of the basket portion. The basket-type grasping forceps according to claim 1, wherein the pair is formed by arranging two elastic wires. 2. The basket-type grasping forceps according to claim 1, wherein at least one set of the elastic wires of the set is folded back at the proximal end and is continuous. 4. The basket-type grasping forceps according to claim 3, wherein all of the sets of elastic wires are continuous. The tip end portion of the basket portion has a through hole formed by a space surrounded by the folded portion of the elastic wire, and the through hole is capable of inserting a guide wire. Basket-type grasping forceps.

Images