JP2006239139A - Instrument for endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an instrument for an endoscope which is easy to curve while keeping compression proofness required to an insertion part of the instrument for the endoscope. <P>SOLUTION: The insertion part 2 of the instrument for the endoscope consists of a short sheath 20 and a long sheath 21, and the long sheath 21 is constituted by binding two or more joint pieces 22 in series. Each joint piece 22 has tapered parts 24 and 28 at its distal end and rear end, and long plane parts 25 and 29 are formed by the tapered parts 24 and 28 at the end of the joint piece 22. The joint pieces 22 adjacent to each other make the plane parts 25 and 29 into surface contact with each other when the long sheath 21 is extended linearly. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to an endoscope treatment tool that is used by being inserted through an endoscope and performs treatment inside the body.

  The endoscope treatment tool has a treatment portion for performing treatment inside the body, and this treatment portion is provided at a distal end portion of a long insertion portion. The insertion portion is mainly inserted through the treatment instrument channel of the endoscope, and is long and flexible. Such an insertion part is known to be composed of a closely wound coil sheath (see, for example, Patent Document 1). However, the insertion portion made of the coil sheath has high compression resistance, but has a large restoring force when it is bent, so that it is difficult to store it in a small size.

  For this reason, the insertion part which arrange | positioned the cylindrical member along the longitudinal direction and connected easily with the pin has been developed (for example, refer patent document 2, patent document 3). In such a cylindrical member, tongue pieces are provided on the distal end side and the proximal end side in the longitudinal direction of the insertion portion, and the tongue pieces of adjacent cylindrical members are overlapped and connected by a pin. If the tongue piece is provided at the same position around the longitudinal axis on the distal end side and the proximal end side of one cylindrical member, the insertion portion can be bent in one direction. Further, if the tongue piece is provided by changing the direction of 90 ° around the axis between the distal end side and the proximal end side of one cylindrical member, the second direction differs from the first direction by 90 ° with respect to the first direction. The insertion portion can be bent in two directions.

As another example of the connecting method of the cylindrical member, a semicircular recessed portion and a protruding portion are provided on each of the distal end side and the proximal end portion of the cylindrical member, and the recessed portion and the protruding portion of the adjacent cylindrical member are provided. There is one in which a joint is formed by fitting (see, for example, Patent Document 4). The retracting portion and the protruding portion have the same shape, and when the insertion portion is extended linearly, the retracting portion and the protruding portion are in close contact with each other. A plurality of control wires are inserted into the cylindrical member, and when the insertion portion is bent, the control wires inserted in a direction in which the insertion portion is desired to be bent are pulled. As a result, at the end of the protrusion, the protrusion moves from the end close to the pulled control wire as a base point so that the protrusion rises from the retracted portion, and the insertion portion is thereby bent.
JP 11-76244 A JP-A-9-262239 JP-A-8-332190 Japanese Patent No. 2578314

However, when performing an internal treatment with the endoscope treatment tool, the insertion portion is moved forward and backward, and the operation wire inserted into the insertion portion is moved forward and backward, so that a compression force acts on the insertion portion. However, when a cylindrical member is connected with a pin, such a compressive force is received by the pin, so that the pin needs to have high strength. Further, when the compressive force is applied, the cylindrical member is easy to rotate with the pin as a base point, so that the shape of the insertion portion is difficult to stabilize. In addition, when the joint is configured with the retracting part and the projecting part, since the projecting part is bent from the retracting part with the end part of the projecting part as a base point during bending, the bendable range is narrow and inserted. The part could not be put together compactly. Furthermore, when the endoscope treatment tool is rolled up and stored, the control wire must be operated, and the workability is poor.
The present invention has been made in view of such circumstances, and an object of the present invention is to bend easily while maintaining the compression resistance required for the insertion portion of the endoscope treatment instrument. Is to be able to.

The invention according to claim 1 of the present invention that solves the above-described problems includes a long insertion portion that is inserted through an endoscope, and a treatment portion that is provided at a distal end portion of the insertion portion and performs a treatment on a living body. An endoscope treatment tool including an operation unit for operating the treatment unit, wherein the insertion unit has a plurality of joint pieces arranged in the longitudinal direction, and the joint pieces have both ends in the longitudinal direction. Each of the portions is formed by the escape portion that reduces the outer circumference toward the other adjacent joint piece and the escape portion, and comes into surface contact with the adjacent joint piece when the insertion portion is a straight line. It was set as the treatment tool for endoscopes characterized by having a plane part.
In this endoscope treatment tool, at least a part of the insertion portion is configured by arranging a plurality of joint pieces. When the insertion part is extended in a straight line, the planar parts of adjacent joint pieces are in surface contact with each other, and when the insertion part is bent, the contact state of the adjacent joint pieces changes. At this time, the joint pieces are relatively movable in the direction in which the relief portions are formed, and can move until the opposite relief portions of adjacent joint pieces come into contact with each other.

According to a second aspect of the present invention, in the endoscope treatment instrument according to the first aspect, an opening of a hole through which a long binding member for connecting the joint piece is formed in the flat portion, and the binding The length of the member is characterized by being longer than the total length of the joint piece when the joint pieces are sequentially penetrated and the plane portions are brought into surface contact with each other.
In this endoscope treatment instrument, a long insertion portion is formed by passing a binding member through holes formed in a plurality of joint pieces. By lengthening the binding member, the joint pieces form a loosely connected state, so that the joint pieces move smoothly.

According to a third aspect of the present invention, there is provided a long insertion portion that is inserted through an endoscope, a treatment portion that is provided at a distal end portion of the insertion portion and performs a treatment on a living body, and an operation that operates the treatment portion. In the endoscope treatment tool including the plurality of joint portions, the insertion portion has a plurality of joint pieces arranged in the longitudinal direction and in surface contact with the convex portion and the concave portion formed of a curved surface, and the outer periphery of the curved surface of the convex portion The length of the endoscope treatment tool is longer than the length of the concave portion along the curved surface.
This endoscopic treatment tool is configured such that at least a part of the insertion portion is provided with a plurality of joint pieces, and when the insertion portion is extended in a straight line, the convex portions and the concave portions of the adjacent joint pieces are formed. Surface contact. When the insertion part is curved, adjacent joint pieces move relatively along the curved surfaces of the convex part and the concave part.

According to a fourth aspect of the present invention, in the endoscope treatment instrument according to the third aspect, the joint piece includes a first joint piece having the convex portions at both ends in the longitudinal direction, and both ends in the longitudinal direction. It has a 2nd joint piece which has the above-mentioned crevice, and, as for said insertion part, said 1st joint piece and said 2nd joint piece are arranged alternately, It is characterized by the above-mentioned.
This endoscopic treatment tool forms an insertion portion by alternately arranging first joint pieces having convex shapes at both ends and second joint pieces having concave shapes at both ends.

  According to the present invention, at least a part of the insertion portion is composed of a plurality of joint pieces, and the adjacent joint pieces are in surface contact with each other when the insertion portion is extended linearly. Since the adjacent joint piece receives the compression force generated by the surface, the compression resistance can be improved. Furthermore, since the bending of the insertion portion is allowed by the escape portion or the curved surface, the elastic force at the time of bending is reduced, and the flexibility can be increased. Therefore, the insertion portion can be easily wound and stored, and the insertion portion is not loaded even if it is wound small.

(First embodiment)
Hereinafter, a first embodiment of the present invention will be described in detail with reference to the drawings.
As shown in FIG. 1, the endoscope treatment tool 1 has a long insertion portion 2, a treatment portion 3 is provided at a distal end portion of the insertion portion 2, and a proximal end portion of the insertion portion 2 is provided at a proximal end portion. An operation unit 4 is provided.

As shown in FIGS. 2 and 3, the treatment section 3 has an elongated support member 5 that is fixed to the distal end of the insertion section 2. The support member 5 is provided with slits 6 along the longitudinal direction from the front end side. An elongated arm portion 8 of a pair of gripping members 7 is inserted into the slit 6, and the arm portion 8 is rotatably supported by the support member 5 with a pin 9. The gripping member 7 has a cup 10 at the distal end portion of the arm portion 8, and the proximal end portion of the arm portion 8 is connected to the link mechanism 11 with a pin. These gripping members 7 are arranged so that the cups 10 face each other, and each link mechanism 11 is connected to the distal end portion of the operation wire 12 that is inserted into the insertion portion 2 so as to freely advance and retract. Accordingly, when the operation wire 12 is advanced, the pair of gripping members 7 is opened, and when the operation wire 12 is retracted, the pair of gripping members 7 can be closed.
As shown in FIG. 1, the operation unit 4 has a slender operation unit main body 15 with a slider 16 attached to the operation unit 4 so as to freely advance and retract. The proximal end portion of the operation wire 12 is fixed to the slider 16, and when the slider 16 is advanced or retracted relative to the operation portion main body 15, the operation wire 12 is advanced or retracted accordingly.

  Here, the insertion portion 2 includes a short sheath 20 to which the treatment portion 3 is fixed, and a long sheath 21 that is continuous with the proximal end portion of the short sheath 20 and is longer than the short sheath 20. An operation wire 12 is inserted into the inside 21 so as to freely advance and retract. The short sheath 20 is composed of a closely wound coil sheath. As shown in FIGS. 2 and 3, the long sheath 21 has a substantially cylindrical joint piece 22 disposed along the longitudinal direction thereof, and an operation wire 12 and a binding wire 23 are inserted through the long sheath 21. Is formed.

  At the tip of the joint piece 22, a tapered portion 24, which is a relief portion of this embodiment, is reduced in the outer circumference (height in the vertical direction in FIG. 2) toward the tip in a sectional view in one diameter direction. Is provided. The tapered portion 24 is formed of a flat surface, and one of the same shape is provided at a position symmetrical about the central axis in the longitudinal direction of the joint piece 22. As shown in FIG. 4, an elongated flat surface portion 25 is formed at the distal end portion of the joint piece 22 by the tapered portion 24. A tip opening of the through hole 26 is formed in the center of the flat portion 25. Furthermore, in the direction orthogonal to the one diameter direction in which the taper portion 24 is formed (the left-right direction in FIGS. 2 and 4), the tip openings of the two binding through holes 27 are formed so as to sandwich the through hole 26. ing. As shown in FIG. 3, the through holes 26 and 27 extend along the longitudinal direction of the joint piece 22. The through hole 26 has a sufficiently larger diameter than the operation wire 12, and the other two binding through holes 27 have a smaller diameter than the through hole 26, but have a sufficiently larger diameter than the binding wire 23. is doing. Further, the proximal end portion of the joint piece 22 has a similar shape. That is, in FIG. 2, a pair of tapered portions 28 whose height decreases from the vertical direction toward the proximal end, and a long flat surface portion 29 formed at the proximal end by these tapered portions 28 are provided. In the flat portion 29, the base end openings of the through holes 26 and 27 are formed in the same arrangement.

Such joint pieces 22 are bound in a state of being aligned in a row by passing the binding wire 23. The distal end of the binding wire 23 is fixed to the proximal end of the short sheath 20. The proximal end portion of the binding wire 23 is fixed to the joint piece 31, and the entire length of the binding wire 23 is longer than the length when the long sheath 21 is linearly extended. It is slowly connected.
When the long sheath 21 is linear, the opposing flat portions 25 and 29 of adjacent joint pieces 22 are brought into surface contact. In addition, a joint piece 30 in which a tapered portion 28 and a flat surface 29 are provided only at the base end portion is used for a connecting portion between the short sheath 20 and the long sheath 21. A joint piece 31 in which a tapered portion 24 and a flat surface portion 25 are provided only at the distal end portion is used for a connecting portion between the long sheath 21 and the operation portion main body 15 of the operation portion 3.

Next, the operation of this embodiment will be described.
First, when storing the endoscope treatment tool 1, the insertion portion 2 is wound in a small loop shape. Since the bundling wire 23 and the operation wire 12 have a sufficient length, as shown in FIG. 5, the long sheath 21 of the insertion portion 2 is brought into contact with the taper portions 24 and 28 facing each other. As a result, the entire insertion portion 2 is curved and is compact. The long sheath 21 can be bent until the opposing tapered portions 24 and 28 of adjacent joint pieces 22 are in surface contact with each other.

  When performing a procedure, the endoscope is first inserted into the body, and the endoscope treatment tool 1 is inserted through the treatment tool channel of the endoscope. First, the treatment part 3 is inserted, and the insertion part 2 connected to the treatment part 3 is inserted into the treatment instrument channel sequentially from the short sheath 20. At this time, the long sheath 21 is inserted while being curved as a whole while maintaining the state in which the planar portions 25 and 29 or the tapered portions 24 and 28 facing each other of the adjacent joint pieces 22 are in contact with each other. Since the treatment instrument channel has a shape close to a straight line, in the treatment instrument channel, the long sheath 21 extends in a straight line with the adjacent joint pieces 22 bringing the flat portions 25 and 29 into surface contact with each other.

  When the treatment section 3 is guided to the treatment target site through the endoscope, the slider 16 of the operation section 4 is advanced relative to the operation section main body 15 to open the pair of gripping members 7. In this state, after the cup 10 of the gripping member 7 is pressed against the treatment target site, the slider 16 is retracted. The pair of gripping members 7 are closed, and the tissue of the treatment target site is stored in the cup 10. When the entire endoscope treatment tool 1 is retracted in this state, the tissue of the treatment target site is torn off. When the endoscope treatment tool 1 is removed from the treatment tool channel, the tissue of the treatment target region is collected. When the procedure is completed in this way, after washing and sterilization, etc., the insertion portion 2 is wound in a loop and stored in the same manner as described above.

According to this embodiment, since the insertion portion 2 has the long sheath 21 formed by arranging a plurality of joint pieces 22 in series, when the insertion portion 2 is extended in a straight line, the planes of the adjacent joint pieces 22 facing each other. The portions 25 and 29 are in surface contact with each other, and a high compression resistance is obtained. For this reason, the insertion part 2 does not buckle when the treatment part 3 is operated. At this time, since the joint piece 22 is in surface contact, the insertion portion 2 can be stably used in a shape close to a straight line.
Further, since the joint pieces 22 are provided with the taper portions 24 and 28 so as to face the flat portions 25 and 29, the long sheath 21 can be easily bent until the opposing taper portions 24 and 28 are in surface contact with each other. The endoscope treatment instrument 1 can be compactly assembled. Here, since the diameters of the through holes 26 and 27 and the lengths of the wires 12 and 23 are set so as to allow the deformation of the long sheath 21, the insertion portion 2 can be easily bent. . Furthermore, since there is no portion that strongly connects adjacent joint pieces 22, separate members, or the like, no force is generated to restore the connection state of the joint pieces 22 to a straight line. Therefore, it is possible to maintain a state in which the insertion portion 2 is compactly assembled, and the endoscope treatment instrument 1 can be easily stored and stored.

(Second Embodiment)
A second embodiment of the present invention will be described in detail with reference to the drawings. In addition, the same code | symbol is attached | subjected to the same component as 1st Embodiment. In addition, overlapping description is omitted.
The endoscope treatment tool according to this embodiment is different from the first embodiment in the configuration of the long sheath. As shown in FIG. 6, the insertion portion 41 of the endoscope treatment tool 40 has a long sheath 42, and the long sheath 42 has first joint pieces 43 and second joint pieces 44 arranged alternately. Configured.

  As shown in FIG. 7 to FIG. 9, the first joint piece 43 has a cylindrical shape in which a through hole 26 into which the operation wire 12 is inserted is formed in the center, and has a distal end portion and a proximal end portion, respectively. The flat portion 25 is formed in a long shape by the taper portion 24. The flat surface portion 25 has a hemispherical recess 45 formed at the center, and a tip opening of the through hole 26 is formed at the center of the recess 45. Similarly, a hemispherical recess 46 is formed at the center of the flat surface portion 29 on the rear end side, and a base end opening of the through hole 26 is formed at the center of the recess 46.

  Further, the second joint piece 44 is formed of a cylindrical member in which a through hole 47 into which the operation wire 12 is inserted is formed in the center, and the protruding portion 49 is in a radial direction at a symmetrical position around the central axis of the cylindrical member. Projects outward. The protrusion 49 is provided at the approximate center in the longitudinal direction of the second joint piece 44, and the length thereof is smaller than the length of the second joint piece 44. The projecting portion 49 is provided with a bundling through hole 48 for inserting the bundling wire 23 in parallel with the longitudinal direction. Further, a hemispherical convex portion 50 and a convex portion 51 are formed on the front end portion and the rear end portion of the second joint piece 44, respectively. The maximum outer diameter of the convex portions 50 and 51 is equal to the outer diameter of the second joint piece 44. The curvature of the curved surfaces of the convex portions 50 and 51 is the same as the curvature of the curved surfaces of the concave portions 45 and 46 of the first joint piece 43.

  In the first and second joint pieces 43 and 44, the operation wire 12 is inserted through the first joint piece 43 and the second joint piece 44 alternately in order, and the binding wire 23 is passed through the first joint piece 43. The long sheath 42 is formed by gently connecting the holes 27 and the bundling through holes 48 of the protrusions 49 of the second joint piece 44 alternately and sequentially. At this time, the opposing concave portions 45 and 46 and convex portions 50 and 51 of the adjacent first joint piece 43 and second joint piece 44 are brought into surface contact with each other between the curved surfaces. When the insertion portion 41 is curved, the convex portions 50 and 51 are slid relative to the concave portions 45 and 46 along the curved surface. As a result, as shown in FIG. 10, the relative orientation of the second joint piece 44 with respect to the first joint piece 43 changes while maintaining surface contact. Since the concave portions 45 and 46 and the convex portions 50 and 51 are spherical, the direction of the first and second joint pieces 43 and 44 is not limited to one direction.

  According to this embodiment, the insertion portion 41 is configured to be bendable by alternately arranging the two types of joint pieces 43 and 44 having the hemispherical concave portions 45 and 46 and the convex portions 50 and 51. The degree of freedom in the bending direction of the insertion portion 41 is increased, and handling is facilitated. In addition, within the movable range of the first and second joint pieces 43 and 44, the first and second joint pieces 43 and 44 adjacent to each other can always be brought into surface contact, and high resistance to compressive force can be obtained. . Other effects are the same as those of the first embodiment.

As shown in FIG. 11, the concave portions 45 and 46 are formed of a circular rotating body smaller than the hemisphere, and the length of the curved surface of the convex portions 50 and 51 is made larger than the length of the curved surface of the concave portions 45 and 46. Also good. If comprised in this way, it will become possible to change the direction of the 2nd joint piece 44 largely with respect to the 1st joint piece 43, so that the curved surface of the convex parts 50 and 51 is long, and the insertion part 41 is put together more compactly. It becomes possible.
Further, as shown in FIG. 12, a tapered portion 60 having a large inclination may be formed at the distal end portion of the first joint piece 43 so as to reach the concave portion 45. In this case, a further elongated flat surface portion 61 is formed. Similarly, a tapered portion 62 having a large inclination is formed at the proximal end portion of the first joint piece 43 so as to reach the concave portion 46 (see FIG. 7), so that the planar portion 63 is further elongated. With this configuration, the concave portions 45 and 46 are partially cut away by the tapered portions 60 and 62, so that the length of the curved surface of the concave portions 45 and 46 is relatively curved in this direction. Shorter than. Therefore, the direction of the second joint piece 44 can be largely changed with respect to the first joint piece 43 in the direction in which the tapered portions 60 and 62 are formed.

(Third embodiment)
A third embodiment of the present invention will be described in detail with reference to the drawings. In addition, the same code | symbol is attached | subjected to the same component as each said embodiment. In addition, overlapping description is omitted.
As shown in FIG. 13, the endoscope treatment tool 70 according to this embodiment includes a storage device 71 that can wind up the insertion portion 2. The insertion unit 2 is described as the insertion unit 2 of the first embodiment, but may be the insertion unit 41 of the second embodiment.

  As shown in FIGS. 13 and 14, in the storage device 71, a winding member 73 is rotatably supported in a storage main body 72. The housing main body 72 has an opening 74 that can pass through the insertion portion 2 at the distal end surface, and a protruding portion 75 that protrudes from the bottom. A mounting portion 76 that can be attached to the endoscope is provided at the end of the protruding portion 75. A circular hole 78 is formed in the side surface 77 of the storage main body 72, and a central portion of the winding member 73 that is circular in side view is partially exposed from here. As shown in FIG. 15, the winding member 73 can wind up the insertion portion 2 on its outer peripheral portion, and a notch 79 is formed at the center of one side facing the hole 78 of the storage body 72. Has been. The other side is supported by the storage body 72 by a bearing 80. A passage 81 is formed from the notch 79 toward the outer peripheral surface of the winding member 73, and the base end portion of the long sheath 21 is fixed to the passage 81. The operation wire 12 in the long sheath 21 extends into the passage 81 and is guided to the notch 79.

  The proximal end portion of the operation wire 12 is pulled out from the passage 81 to the notch 79 and attached to a connection portion 82 provided in the notch 79. The connection portion 82 extends along the axial direction of the passage 81, and a first connection portion 83 on the side of the passage 81 and a second connection connected to the first connection portion 83 by a coiled spring member 84. Part 85. The first connecting portion 83 has a tubular member 86 formed with a through-hole through which the operation wire 12 can be advanced and retracted. A flange portion 87 having an enlarged diameter is provided at the end of the tubular member 86. The second connection portion 85 includes a first wire end portion 88 to which the proximal end portion of the operation wire 12 is fixed, and a second wire portion 88 connected to the first wire end portion 88 via the tubular member 89. And wire end 90.

Next, the operation of this embodiment will be described.
When storing the endoscope treatment tool 70, the insertion portion 2 is wound around the winding member 73. When the contact position of each joint piece 22 of the long sheath 21 is shifted, the insertion portion 2 is curved so as to follow the outer periphery of the winding member 73.
As shown in FIG. 16, when using the endoscope treatment tool 70, the storage device 71 is attached to the endoscope operation unit 91 of the endoscope 90. Note that an engaging member 92 projects from the side of the endoscope operation unit 91, and a treatment instrument insertion port 93 is opened in the engaging member 92. The treatment instrument insertion port 93 is an insertion port for a treatment instrument channel 95 that opens at the distal end portion of the flexible endoscope insertion portion 94. Further, the engaging member 92 is provided with an engaging hole 96, and the attachment portion 76 of the storage device 71 can be engaged with the engaging hole 96.
When the storage device 71 is attached to the endoscope 90, the treatment section 3 is pulled and inserted into the treatment instrument channel 95 from the treatment instrument insertion port 93. Thereafter, until the treatment section 3 reaches the distal end of the treatment instrument channel 95, the insertion section 2 is unwound from the winding member 73 and inserted.

  Here, in the endoscope treatment tool 70, when operating the treatment section 3, the operation section 100 is mounted on the connection section 82 exposed from the hole 78 of the storage device 71. The operation unit 100 according to this embodiment is detachably attached to the storage device 71 and is configured by connecting intermediate portions of a pair of hook-shaped members 101 and 102 with pins 103. At the base ends of the hook-shaped members 101, 102, there are finger hooks 104, and a ratchet 105 is disposed between the finger hooks 104. The ratchet 105 is made of an elastically deformable material, and protrudes inwardly to extend so as to be able to intersect with each other. On the intersecting surface of the ratchet 105, jaw-like teeth that can be engaged with each other are formed. The teeth are slidable only in the direction approaching each other, and the opening degree of the pair of hook-shaped members 101 and 102 can be maintained even if the hand is released from the finger-hanging portion 104.

  As shown in FIG. 17, the tubular member 86 of the first connecting portion 83 of the connecting portion 82 is engaged with a U-shaped engaging portion provided at the tip of one hook-shaped member 102 from the passage 81 side. Then, the tubular member 89 of the second operation portion 85 is engaged with a U-shaped engagement portion provided at the tip of the other hook-shaped member 101. When a finger is placed on the finger rest 104 and the ratchet 105 is disengaged, and then the end of the pair of hook-shaped members 101 and 102 is operated, the second connecting portion is contracted while the spring member 84 is contracted. 85 approaches the first connection portion 83 side, the operation wire 12 fixed to the second connection portion 85 moves forward, and the pair of gripping members 7 connected to the tips of the operation wires 12 are opened. When the opened gripping member 7 is pressed against the treatment target site, the distal ends of the pair of hook-shaped members 101 and 102 of the operation unit 100 are opened. As a result, the second connecting portion 85 is separated from the first connecting portion 83 by the restoring force of the spring member 84, and the operation wire 12 fixed to the second connecting portion 85 is pulled back. As a result, the pair of gripping members 101 and 102 are closed, and the tissue of the treatment target site is sandwiched in the cup 10. Since the state in which the gripping member 7 is closed in this way can be maintained by the ratchet 105, when the exposed insertion portion 2 is pulled between the treatment instrument insertion port 93 and the storage body 72 in this state, the treatment target region The tissue is torn and collected. In addition, when inserting the insertion part 2 in the endoscope 90 and the action in the inserted state, it is the same as that of 1st Embodiment.

  In this embodiment, by providing the storage device 71, it is easy to collect the insertion portion 2 in a compact manner, and handling when the insertion portion 2 is inserted into and removed from the endoscope 90 can be facilitated. Further, by making the storage device 71 detachable from the endoscope 90, the endoscope treatment tool 70 can be attached to the endoscope 90 and used only when necessary. Furthermore, since the operation unit 100 is configured to be detachable, the operation unit 100 can be removed when the insertion unit 2 is wound or inserted / removed, and the operation unit 100 can be prevented from interfering with the surroundings. The effect of the insertion portion 2 having the long sheath 21 is the same as that of the first embodiment.

(Fourth embodiment)
A fourth embodiment of the present invention will be described in detail with reference to the drawings. In addition, the same code | symbol is attached | subjected to the same component as each said embodiment. In addition, overlapping description is omitted.
As shown in FIGS. 18 and 19, the endoscope treatment tool 110 according to this embodiment is a monorail treatment tool guided by a guide wire 111 and guided to a treatment target site. For this reason, the treatment portion 3 is provided with a tubular portion 113 protruding from the side portion of the support member 5, and a guide through-hole 112 through which a guide wire is inserted is formed. The insertion portion 114 is configured by a long sheath 115 gently connecting a plurality of joint pieces 116 with a binding wire 23. In the joint piece 116, elongated flat portions 25 and 29 are formed by tapered portions 24 and 28, and three through holes 26 and 27 are opened in the flat portions 25 and 29.

  Here, as shown in FIGS. 19 to 21, the joint piece 116 has the joint piece 116 so that the slit 117 cuts out part of the tapered portions 24 and 28 in the same direction as the protruding direction of the tubular portion 113. 116 is provided so as to extend along the longitudinal direction of 116. The slit 117 is larger than the diameter of the guide wire 111 and is formed so that the entire guide wire 111 can be inserted therein.

  Such an endoscopic treatment tool 110 is used, for example, for treatment of a bile duct connected to the duodenum. In this case, the distal end portion of the guide wire 111 is inserted into the bile duct from the duodenal papilla in advance, and the proximal end portion of the guide wire 111 is passed through the guide through hole 112 of the treatment portion 3, and then the slit of the joint piece 116. The guide wire 111 is pulled into the 117. Then, the endoscope treatment instrument 110 is inserted into the body through the guide wire 111, and the treatment section 3 is advanced into the bile duct. The subsequent treatment is the same as described above.

  According to this embodiment, since the endoscope treatment tool 110 can be guided to the treatment target site using the guide wire 111, the procedure becomes easy and the procedure time can be shortened. The action and effect when the insertion portion 114 is bent are the same as those in the first embodiment.

The present invention can be widely applied without being limited to the above embodiments.
For example, the joint piece 22 of the first embodiment may be provided with tapered portions 60 and 62 as shown in FIG. Further, the proximal end side taper portion 28 may be provided at a position shifted by 90 ° around the axis with respect to the distal end side taper portion 24 of the joint piece 22. The insertion portion 2 can be bent in two directions.
Like the joint piece 120 shown in FIG. 22, the taper portions 24 and 28 may be provided 90 degrees around the central axis of the joint piece 120, and the flat portions 121 and 122 may be formed at the front and rear ends. With this configuration, the long sheath can be bent in four directions. The joint piece 120 is bound only by the operation wire 12 without using the binding wire 23. The connecting pieces 22, 43, 44, and 116 in each of the above embodiments may be connected only by the operation wire 12 without using the binding wire 23.

As in the joint piece 130 shown in FIG. 23, tapered portions 133 and 134 may be provided so that circular flat portions 131 and 132 are formed at the distal end and the proximal end. Thus, it becomes possible to set freely the bending direction of a long sheath by making a front-end | tip part and a rear-end part into a truncated cone shape.
A long sheath may be constituted by the first joint piece 140 and the second joint piece 141 shown in FIG. The first joint piece 140 has bowl-shaped convex portions 142 and 143 at the front end and the rear end, respectively, and through holes 26 and 27 are opened on the curved surfaces thereof. The second joint piece 141 has concave portions 144 and 145 at the distal end and the proximal end, respectively. The concave portions 144 and 145 have a shape that can come into surface contact with the convex portions 142 and 143, and the lengths of the curved surfaces of the concave portions 144 and 145 are the same as or shorter than the curved surfaces of the convex portions 142 and 143. Through holes 26 and 27 are opened in the curved surfaces of the recesses 144 and 145, and the first joint piece 140 and the second joint piece 141 are alternately arranged in order by the operation wire 12 and the binding wire 23. A long sheath is formed. In the first and second joint pieces 140 and 141, the long sheath can be bent along the curved surface.
Furthermore, the endoscope treatment instrument is not limited to the configuration shown in the above embodiment as long as it has a configuration for driving the treatment portion by moving the operation wire forward and backward with respect to the long sheath.

(Additional item 1)
The endoscope treatment instrument according to claim 1, further comprising a storage device having a winding member that winds the insertion portion.
(Appendix 2)
5. The internal view according to claim 1, wherein a slit through which a guide wire inserted into the body can go in and out is provided on an outer periphery of the joint piece along a longitudinal direction of the insertion portion. Mirror treatment tool.

It is a figure showing the whole endoscope treatment instrument composition concerning an embodiment of the invention. It is an enlarged view of the front-end | tip part of a treatment part and an insertion part. FIG. 3 is a view as seen from an arrow A in FIG. 2. It is a perspective view of a joint piece. It is a figure which shows the example of arrangement | positioning of a joint piece when an insertion part is curved. It is a figure which shows the whole structure of the treatment tool for endoscopes. It is an enlarged view of the front-end | tip part of a treatment part and an insertion part. It is a B arrow line view of FIG. It is a perspective view of a joint piece. It is a figure which shows the example of arrangement | positioning of a joint piece when an insertion part is curved. It is a side view which shows the structure of a connection piece. It is a perspective view of a connection piece. It is a perspective view of the treatment tool for endoscopes. It is sectional drawing along CC line of FIG. It is sectional drawing along the DD line | wire of FIG. It is a figure explaining the use condition of the treatment tool for endoscopes. It is a figure which shows the state which mounted | wore the operation part. It is a figure which shows the whole structure of the treatment tool for endoscopes. FIG. 19 is a partially enlarged view of FIG. 18 in which a guide wire is inserted. FIG. 19 is a partially enlarged view taken along arrow E in FIG. 18. It is a perspective view of a joint piece. It is a perspective view of a joint piece. It is a perspective view of a joint piece. It is a perspective view of a joint piece.

Explanation of symbols

1,40,70,110 Endoscopic treatment tool 2,41,114 Insertion section 3 Treatment section 4 Operation section 22 Joint piece 24, 28, 60, 62, 133, 134 Tapered section (relief section)
23 Ligation wire 27 Through hole (hole)
25, 29, 121, 122 Planar part 43 First joint piece 44 Second joint piece 45, 46, 144, 145 Concave part 50, 51, 142, 143 Convex part

Claims (4)

For an endoscope comprising a long insertion portion that is inserted through an endoscope, a treatment portion that is provided at a distal end portion of the insertion portion and performs a treatment on a living body, and an operation portion that operates the treatment portion In the treatment tool,
The insertion portion has a plurality of joint pieces arranged in the longitudinal direction, and the joint pieces are respectively provided at both end portions in the longitudinal direction to reduce the outer circumference toward the other adjacent joint pieces. And a planar portion that is formed by the relief portion and is in surface contact with another joint piece adjacent to the insertion portion when the insertion portion is a straight line.   An opening of a hole that penetrates a long binding member that connects the joint pieces is formed in the flat portion, and the length of the binding member passes through the joint pieces in order, and the flat portions are in surface contact with each other. The endoscopic treatment tool according to claim 1, wherein the length of the joint piece is longer than the total length of the joint piece. For an endoscope comprising a long insertion portion that is inserted through an endoscope, a treatment portion that is provided at a distal end portion of the insertion portion and performs a treatment on a living body, and an operation portion that operates the treatment portion In the treatment tool,
The insertion portion has a plurality of joint pieces arranged in a longitudinal direction and in surface contact with a convex portion and a concave portion made of a curved surface, and the length along the outer periphery of the curved surface of the convex portion is the curved surface of the concave portion An endoscopic treatment tool characterized by being longer than the length along. The joint piece includes a first joint piece having the convex portions at both ends in the longitudinal direction and a second joint piece having the concave portions at both ends in the longitudinal direction, and the insertion portion includes the first joint piece. The endoscope treatment tool according to claim 3, wherein the pieces and the second joint pieces are alternately arranged.

Images