JP2007301285A - High-frequency treatment instrument - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To improve operability by improving transmission of operation force in a flexible sheath and minimizing resistance to curving operation of an angle part. <P>SOLUTION: Regarding a conductor cord 11 of a treatment instrument main body 10 put through the inside of a flexible sheath 2, a proximal end side is formed of a conductor 11a, a hollow wire 11b is connected to the distal end of the conductor wire 11a, and a high frequency knife 13 is connected to the distal end of the hollow wire 11b. The conductor wire 11a constituting the conductor cord 11 is formed of a wire having a prescribed diameter. The hollow wire 11b is constituted by making an elastic and thin metallic wire multi-thread to have a shape of a belt piece F and winding the belt piece F closely and spirally, and the hollow wire 11b is flexible in a curving direction. The distal end of the conductor wire 11a is inserted to the hollow wire 11b, and fixed reliably by a means of brazing etc. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to a high-frequency treatment instrument that is inserted into a treatment instrument insertion channel of an endoscope and performs treatments such as excision, incision, hemostasis, and coagulation of a diseased tissue.

  For example, if it is discovered by endoscopy that a diseased tissue is present on the inner wall of the body cavity, a treatment is performed to remove the lesioned mucous membrane using a high-frequency treatment tool. Is performed under the control of an endoscope. The endoscope includes a treatment instrument insertion channel, and the high-frequency treatment instrument is inserted into the treatment instrument insertion channel and guided to a site to be treated. In a high-frequency treatment instrument for performing incision of a body tissue such as a mucous membrane or other treatments, for example, a high-frequency knife made of an electrode member having a rod-like portion is used as a high-frequency treatment member.

  A conductive wire connected to a high frequency power source is connected to the high frequency knife, and is mounted inside a flexible sheath having electrical insulation. A handle member for operation is connected to the proximal end portion of the flexible sheath, and the proximal end portion of the conductive wire inserted into the flexible sheath is connected to a slider provided on the handle member. The high-frequency knife as the high-frequency treatment member is controlled so as to appear and disappear from the distal end of the flexible sheath by displacing the slider manually. A guide made of a member having excellent electrical insulation and heat resistance is provided in the distal end portion of the flexible sheath so as to restrict the most protruding position of the high-frequency knife and stabilize the high-frequency knife from swinging during operation. The tube is inserted and fixed.

As a method for connecting a conductive wire to a high-frequency knife, for example, the method disclosed in Patent Document 1 has been known. In this known high-frequency treatment instrument, a high-frequency knife is formed by plasma processing the tip of a conductive operation wire, and a high-frequency knife is formed by a guide tube at the transition between the tip of the control wire and the high-frequency knife. A stopper for restricting the amount of protrusion is provided. That is, the tip of the operation wire can be processed into a desired shape by the action of heat generated by the plasma, and can be hardened while maintaining a predetermined shape by cooling.
JP-A-63-97154

  An endoscope for performing operation control of a high-frequency treatment instrument has a configuration in which an insertion portion to be inserted into a patient's body is connected to a main body operation portion. The insertion part is a flexible part that bends along the insertion path for most of the length from the connection side to the main unit operation part.An angle part is connected to this flexible part, and a hard tip part is connected to the angle part. Provided. An endoscope observation means including an illumination part and an observation part is provided at the distal end hard part. The angle portion can be bent so that the distal end hard portion is directed in a desired direction.

  The treatment instrument insertion channel provided in the endoscope is a passage that extends from the treatment instrument introduction part to which the forceps plug provided in the main body operation part is attached to the entire length of the insertion part. It opens in the vicinity of the mounting part of the mirror observation means. When the high-frequency treatment instrument is inserted into the treatment instrument insertion channel, the high-frequency knife is accommodated in the flexible sheath. In performing a treatment using the high-frequency treatment instrument, the flexible sheath of the high-frequency treatment instrument inserted from the treatment instrument introduction unit is led out from the distal end of the treatment instrument insertion channel, and then the high-frequency treatment instrument is guided from the distal end of the flexible sheath. Make the knife protrude. This operation is performed by pushing and pulling the slider on the handle member provided at the proximal end of the flexible sheath. Then, with the high-frequency knife protruding from the tip of the flexible sheath, treatment such as incision is performed by energizing the high-frequency knife. The high-frequency knife is inserted into the guide tube from the inner surface of the flexible sheath. After the transition, it protrudes from the tip to the outside.

  When the operation wire inserted into the flexible sheath is operated on the slider of the handle member, it is necessary to apply the operation force to the position of the high-frequency knife at the tip. For this purpose, the operation wire is provided with a certain degree of rigidity so as to reliably follow the operation of the slider. On the other hand, in the insertion portion of the endoscope, in order to enable an angle operation in a narrow place, the radius of curvature at the time of bending in the angle portion is extremely small. As described above, if the rigidity of the operation wire inserted into the flexible sheath of the high-frequency treatment instrument is increased, the resistance to the bending operation becomes extremely large, and this angle operation becomes difficult.

  In short, considering the transmission efficiency of the pushing force to the high-frequency knife, it is better to increase the rigidity of the operation wire, and from the operability of the bending operation of the angle part in the insertion part of the endoscope, it has high rigidity in the bending direction. An operating wire is undesirable. Further, when a guide member is mounted in the distal end portion of the flexible sheath, in order to make a smooth transition to the guide member, there is a certain bending direction at the connecting portion between the high-frequency knife and the operation wire. It is desirable to have flexibility, and when the treatment is performed with a high-frequency treatment instrument in a state where the angle portion is bent at a large angle, and thereafter the bending of the angle portion is released, the operation wire has a bending rod or the like. It must not be attached and must be restored to a straight state.

  The present invention has been made in view of the above points. The object of the present invention is that when the operation force is transmitted in the flexible sheath and the angle portion is bent, An object of the present invention is to provide a high-frequency treatment instrument having high operability so that resistance to bending operation can be minimized.

  In order to achieve the above-described object, the present invention provides a flexible sheath that can be inserted into a treatment instrument insertion channel of an endoscope, and a high-frequency wave provided at the distal end of a conductor cord. A treatment instrument body provided with a high-frequency treatment member to which an electric current is applied, and a handle member connected to a proximal end portion of the flexible sheath, and the distal end of the flexible sheath is operated by operating the handle member A high-frequency treatment instrument in which a guide tube that guides the high-frequency treatment member so as to protrude and retract from the flexible sheath is inserted and fixed, wherein the conductor cord is connected to the high-frequency treatment member and a metal wire is tightly wound. A hollow wire that is spirally wound into a cylindrical shape and a conductive wire that is inserted into and fixed to the proximal end portion of the hollow wire, and the hollow wire includes the flexible sheath and the endoscope. Treatment instrument insertion channel When inserted into the endoscope, at least the length from the distal end of the endoscope insertion portion to the proximal end portion of the angle portion is longer, and the proximal end portion of the conductive wire fixed to the hollow wire is the handle member. It is characterized in that it is connected so that it can be pushed and pulled.

  Here, the high-frequency treatment member performs a treatment such as cauterization of the affected area by flowing a high-frequency current, and the treatment tool body is constituted by a high-frequency knife, a biopsy forceps, a high-frequency snare, or the like. Moreover, although a hollow wire is comprised from what wound the metal wire rod in the closely wound spiral shape, it can be set as a close_contact | coating coil more specifically. The close contact coil may be formed by winding a single metal wire, but is a so-called multi-strand winding in which a plurality of metal wires are arranged in a strip shape, for example, about 5 to 10 It is desirable that the metal wire is arranged in a strip shape and spirally wound.

  As described above, when the conductor cord provided in the flexible sheath is inserted into the treatment instrument insertion channel of the endoscope, the portion located in the angle portion of the insertion portion of the endoscope Because it is a hollow wire having high flexibility in the bending direction, when the angle part is bent, resistance to this bending operation can be minimized, and it is located in a soft part that cannot be bent as much as the angle part. Since the portion is composed of a conductive wire, by imparting rigidity to the conductive wire, it is possible to improve the transmission of the pushing operation force to the treatment member in the flexible sheath and to improve the operability of the high-frequency treatment instrument as a whole. Can do.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. First, FIG. 1 shows the overall configuration of the high-frequency treatment instrument, and FIG.

  First, in FIGS. 1 and 2, reference numeral 1 denotes a high-frequency treatment instrument. The high-frequency treatment instrument 1 has a long flexible sheath 2, and a connection pipe is connected to a proximal end portion of the flexible sheath 2. 3 is connected, and a handle member 4 is connected to the other end of the connection pipe 3. The handle member 4 includes a main body shaft 4a coupled to the connection pipe 3, and a slider 4b that is fitted to the main body shaft 4a and is slidable in the axial direction of the main body shaft 4a. A base end portion of a conductor cord 11 constituting the treatment instrument main body 10 is connected to the slider 4b. A base end portion of the conductor cord 11 protrudes a predetermined length from a connecting portion to the slider 4b, and a contact portion 12 is provided. The contact portion 12 is detachably connected to a high frequency power supply device (not shown). A high-frequency knife 13 is provided at the tip of the conductor cord 11.

  As shown in FIGS. 3 and 4, the guide tube 20 is inserted and fixed at the distal end portion of the flexible sheath 2. The guide tube 20 is made of a member having good electrical insulation and heat resistance, preferably a ceramic material. A spiral protrusion 20 a is provided on the outer surface of the guide tube 20, so that the guide tube 20 is screwed into the flexible sheath 2. At a position on the proximal end side of the guide tube 20, a calling member 22 for loading the high-frequency knife 13 into the through hole 21 from a position closer to the proximal end than the through hole 21 is mounted. This attracting member 22 is a ring-shaped member made of stainless steel or the like, and its base end surface is a tapered surface 22a that is inclined toward the distal end side from the outer peripheral side toward the inner peripheral side. Thus, the high-frequency knife 13 is called into the through hole 21. That is, the high-frequency knife 13 is normally drawn to the proximal end side from the guide cylinder 20 and is guided from this state toward the through hole 21 along the tapered surface 22a. Is introduced into the through hole 21.

  The conductor cord 11 is composed of a conductive wire 11a for a predetermined length from the base end side, and a hollow wire 11b is connected to the distal end of the conductive wire 11a, and the high-frequency knife 13 is connected to the distal end of the hollow wire 11b. Are connected. The conductive wire 11a constituting the conductor cord 11 is made of a wire having a predetermined wire diameter, and the hollow wire 11b is made of a hollow flexible tube. As shown in FIG. 5, the hollow wire 11b is formed of a thin metal wire having elasticity to form a strip F, and the strip F is wound in a close spiral shape. It is flexible in the bending direction. And the front-end | tip of the conductive wire 11a is inserted in the hollow wire 11b, and it fixes firmly so that the space | interval may be electrically connected by means, such as brazing. And the high frequency knife 13 is connected with the front-end | tip of the hollow wire 11b, and, thereby, the high frequency knife 13 is electrically connected with the conductor cord 11. Here, the outer surfaces of the conductive wires 11a and the hollow wires 11b constituting the conductor cord 11 are coated with a resin material having electrical insulation, for example, a fluororesin. Thus, when the conductor cord 11 is energized, the current density can be concentrated on the high-frequency knife 13, and the sliding property of the conductor cord 11 with respect to the inner surface of the flexible sheath 2 is improved.

  The high-frequency knife 13 connected to the tip of the hollow wire 11 b has a rod-like electrode 14 that can flow a high-frequency current by supplying power from the conductor cord 11. The rod-shaped electrode 14 has a rod shape whose tip is a spherical shape. Then, at the base end side position of the rod-shaped electrode 14, four blade portions 15 are provided so as to project radially outward at angular positions of 90 °. The tip surface 15 a of the blade portion 15 is an inclined surface for guiding the blade portion 15 to the through hole 21 of the guide tube 20. Further, the outer surface 15b of the blade portion 15 has an arc shape that substantially matches the curvature of the through hole 21, and has a predetermined length. Therefore, when the high-frequency knife 13 is inserted into the through hole 21 of the guide cylinder 20, the outer surface 15 b (FIG. 3) of the four blade portions 15 is substantially in sliding contact with the inner surface of the through hole 21. As a result, the high-frequency knife 13 is aligned with respect to the axis of the guide cylinder 20 and is stably held so that it does not swing excessively even if an external force acts on the tip of the rod-shaped electrode 14. Further, a height difference is formed at the base end side portion of the blade portion 15, and this step wall serves as the stopper surface 15c. The stopper surface 15c can enter up to a position where the stopper surface 15c comes into contact with the base end surface of the guide tube 20 when the high-frequency knife 13 is inserted into the through hole 21 of the guide tube 20. Can not.

  When the high-frequency knife 13 is in the most projecting position, as is apparent from FIG. 3, based on the difference in diameter between the outer diameter and the outer periphery of the shaft portion of the high-frequency knife 13 and the hole diameter of the through hole 21 of the guide cylinder 20. Four generally fan-shaped communication passages 23 are formed in each portion between the blade portions 15 adjacent to each other in the four blade portions 15 described above. And the connection pipe 3 provided in the site | part of the base end side of the high frequency treatment instrument 1 has the connection port 3a, The syringe which supplies liquids, such as a hyaluronic acid solution and a physiological saline, to this connection port 3a, Suction piping etc. can be connected. Therefore, by connecting a syringe filled with a liquid to the connection port 3 a and operating this syringe, the liquid can be ejected from the periphery of the rod-shaped electrode 14 via the communication path 23. Further, when the suction pipe is connected, suction from the communication path 23 becomes possible. The liquid can be supplied and sucked even in a state where the high-frequency knife 13 is arranged on the proximal side from the guide tube 20. Accordingly, by connecting a syringe filled with a hyaluronic acid solution to the connection port 3a, for example, an operation of swelling the lesioned mucosa can be performed. That is, the high-frequency knife 13 is protruded from the distal end of the flexible sheath 2 to incise a part of the mucous membrane, and then the high-frequency knife 13 is drawn into the flexible sheath 2 and the distal end of the flexible sheath 2 is moved. While pressed against the mucosal surface, the lesioned mucosa can be expanded by pumping hyaluronic acid solution from a syringe connected to the connection port 3a and locally injecting it into the submucosa.

  As shown in FIG. 6, the high-frequency treatment instrument 1 having the above configuration is inserted into the body cavity of a subject, for example, the esophagus, stomach, duodenum, large intestine, and the like via the endoscope 30. Become. When the lesioned mucosa is present on the inner wall of the body cavity, the high-frequency knife 13 that constitutes the treatment instrument body 10 inserted into the flexible sheath 2 of the high-frequency treatment instrument 1 is protruded, and the high-frequency knife 13 causes the lesion. It is used to perform a treatment for peeling and removing the mucous membrane part, a treatment for cauterizing the bleeding part for hemostasis, and the like. For this purpose, the high frequency knife 13 can be moved in and out from the distal end of the flexible sheath 2 by moving the slider 4b along the body axis 4a of the handle member 4 connected to the proximal end portion of the flexible sheath 2. It is like that.

  The endoscope 30 into which the high-frequency treatment instrument 1 is inserted is provided by connecting an insertion portion 32 to a main body operation portion 31, and the insertion portion 32 has a predetermined length from the connection side to the main body operation portion 31. The portion is a soft portion 32a that bends freely along the insertion path, and an angle portion 32b and a hard tip portion 32c are successively connected to the soft portion 32a. An endoscope observation means including an illumination part and an observation part is attached to the distal end hard part 32c. In addition, a treatment instrument introduction section 33 is provided in the vicinity of the connection section of the main body operation section 31 to the insertion section 32, and a proximal end portion of the treatment instrument insertion channel 34 is connected to the treatment instrument introduction section 33. . The distal end portion of the treatment instrument insertion channel 34 extends to the distal end hard portion 32 c in the insertion portion 32. The treatment instrument insertion channel 34 opens at the distal end portion of the distal end hard portion 32c in the vicinity of the attachment portion of the endoscope observation means. Accordingly, the high-frequency treatment instrument 1 is inserted into the treatment instrument insertion channel 34 from the treatment instrument introduction section 33 and led out from the distal end hard section 32c, whereby a desired treatment is performed.

  Here, the angle part 32 b in the insertion part 32 of the endoscope 30 can be bent by operating the angle knob 35 attached to the main body operation part 31. Therefore, the distal end hard portion 32c provided with the endoscope observation means can be directed in a desired direction, and treatments by various treatment tools including the high-frequency treatment tool 1 inserted through the treatment tool insertion channel 34 can be smoothly performed. You can do it. As shown in FIG. 6, the angle portion 32b can be bent at an angle of 180 degrees or more, and the radius of curvature is extremely small in order to bend smoothly in a narrow space. . Even in a state where the angle portion 32b is curved as described above, the high-frequency treatment instrument 1 is inserted into the treatment instrument insertion channel 34 to perform the treatment.

  The conductor cord 11 connected to the high-frequency knife 13 is configured to connect the conductive wire 11a and the hollow wire 11b, both of which are formed of members having good conductivity. It is the position near the tip. That is, when the high-frequency treatment instrument 1 is inserted into the treatment instrument insertion channel 34, the hollow wire 11 b is located inside the angle portion 32 b of the insertion portion 32. The conductive wire 11 a connected to the hollow wire 11 b extends to the handle member 4, and the handle member 4 is led out from the treatment instrument introducing portion 33 of the flexible sheath 2.

  Here, the hollow wire 11b is composed of a plurality of conductive metal wires wound in a tightly wound coil shape, and is excellent in flexibility and elasticity in the bending direction and flexible. When pushing straight in the sheath 2, the pushing force is efficiently transmitted. The conductive wire 11a is flexible in the bending direction, but has higher rigidity than the hollow wire 11b and has a certain degree of waist. For this reason, the conductive wire 11a has a desired rigidity and flexibility in the bending direction by increasing the diameter to some extent. Therefore, the conductive wire 11a has a higher transmission efficiency of the pushing force in the flexible sheath 2 than the hollow wire 11b.

  Now, it is assumed that a site to be treated is found while the insertion portion 32 of the endoscope 30 is inserted into the body cavity of the subject and the inspection inside the body cavity is being performed. At this time, the high-frequency treatment instrument 1 is inserted into the treatment instrument insertion channel 34 from the treatment instrument introduction portion 33 and protruded from the distal end hard portion 32c of the insertion portion 32 by a predetermined length to perform necessary treatment. When the high-frequency treatment instrument 1 is inserted into the treatment instrument insertion channel 34, the high-frequency knife 13 of the treatment instrument body 10 is housed in the flexible sheath 2 and protrudes from the distal end of the flexible sheath 2. I won't let you. When the high-frequency treatment instrument 1 is inserted, in the insertion portion 32, the flexible portion 32a may be bent or the angle portion 32b may be curved. The entire conductor cord 11 of the treatment instrument body 10 is flexible in the bending direction, and does not hinder the insertion operation of the high-frequency treatment instrument 1 into the insertion portion 32.

  The flexible sheath 2 of the high-frequency treatment instrument 1 is led out from the distal end hard part 32c of the insertion part 32, and the angle part 32b is bent in a desired direction in order to adjust the direction of the flexible sheath 2 toward the affected part. May be necessary. At this time, since the flexible sheath 2 inserted into the treatment instrument insertion channel 34 passes through the portion of the angle portion 32b, the flexible sheath 2 and the conductor cord 11 inserted through the flexible sheath 2 are angled. Resistance to the bending operation of the portion 32b increases. However, since the conductor cord 11 is located inside the angle portion 32b is the hollow wire 11b having high flexibility in the bending direction, the high-frequency treatment instrument inserted into the treatment instrument insertion channel 34 1, the resistance to the bending operation of the angle portion 32b that is performed manually by the angle knob 35 does not increase so much, and the operability of the angle operation does not deteriorate significantly. Further, it is possible to easily perform the operation of inserting the high-frequency treatment instrument 1 into the treatment instrument insertion channel 34 with the angle portion 32b being bent and leading it out from the distal end hard portion 32c.

  After the distal end of the high-frequency treatment instrument 1 is led out from the distal end hard portion 32 c, the high-frequency knife 13 is projected from the distal end of the flexible sheath 2. This operation is performed by moving the slider 4b of the handle member 4 along the main body axis 4a. The conductor cord 11 constituting the treatment instrument main body 10 is composed of the conductive wire 11a in most of the length from the connecting portion to the slider 4b, that is, inside the soft portion 32a. Therefore, the conductive wire 11a is in the bending direction. Although it has flexibility, it has a considerable waist, so that when the conductive wire 11a is pushed into the flexible sheath 2 by the operation of the slider 4b, the pushing force is reliably transmitted to the tip. The Moreover, although it bends along the insertion path, the bend is located inside the soft portion 32a which is loose, and therefore follows the bend of the soft portion 32a without any problem.

  A hollow wire 11b is connected to the tip of the conductive wire 11a in the conductor cord 11, and a high-frequency knife 13 is connected to the tip of the hollow wire 11b. The hollow wire 11b has a lower transmission efficiency of the pushing force than the conductive wire 11a, but the hollow wire 11b is substantially limited to the inside of the angle portion 32b, and the length of the conductor cord 11 is short. It has become. Therefore, there is no hindrance to the operation of deriving the high-frequency knife 13 from the distal end of the flexible sheath 2. Here, the degree of flexibility in the bending direction of the hollow wire 11b, the elastic force, the rigidity in the straight direction, etc. depend on the metal wire constituting the hollow wire 11b and the number of strips when it is wound spirally. It is determined. Specifically, it is desirable that the number of strips when the hollow wire 11b is wound is about 5 to 10 strips.

  By the way, the tip of the rod-like electrode 14 at the tip of the high-frequency knife 13 has a substantially spherical shape, and when the proximal end portion of the conductor cord 11 is pushed into the flexible sheath 2, Moves smoothly along the inner surface. However, a calling member 22 and a guide tube 20 are attached to the distal end portion of the flexible sheath 2, and as shown in FIG. 7, between the inner surface of the flexible sheath 2 and the end portion of the calling member 22. You may be caught in. However, since the hollow wire 11b has elasticity and the transmission efficiency of the pushing force by the conductive wire 11a is high, a strong pressing force acts on the hollow wire 11b, and as a result, the hollow wire 11b becomes a bow. If it bends and bends to some extent, it will be displaced from the outer peripheral edge part of the calling member 22 to the center part side by the elastic force. Therefore, it moves smoothly and reliably into the through hole 21 of the guide cylinder 20.

  In the high-frequency knife 13, the blade portion 15 provided on the rod-shaped electrode 14 slides along the inner surface of the guide tube 20, and the rod-shaped electrode 14 protrudes from the guide tube 20 by a predetermined length. And the protrusion amount of the high frequency knife 13 is controlled in the position where the stopper surface 15c contacts the end of the guide tube 20. Then, treatment such as incision of the affected part or hemostasis by cauterization is performed while appropriately bending the angle part 32b. Since the bending operation of the angle portion 32b can be smoothly performed with a light load, the position and direction of the high-frequency knife 13 can be accurately controlled.

  When a high-frequency current is passed through the contact portion 12 connected to the high-frequency power supply device, a current flows to the rod-shaped electrode 14 of the high-frequency knife 13 through the conductive wire 11a and the hollow wire 11b that constitute the conductor cord 11. It will be. At this time, a counter electrode plate (not shown) is brought into contact with the body of the subject. When the treatment such as cauterization of the affected part is completed, the high-frequency knife 13 is pulled into the flexible sheath 2 and then the entire high-frequency treatment instrument 1 is taken out from the treatment instrument insertion channel 34 of the endoscope 30.

  When the high-frequency treatment instrument 1 is operated for a long time in a state where the angle portion 32b is bent at a steep angle, the conductor cord 11 is forcibly bent. Therefore, when the bending of the angle portion 32b is released or the high-frequency treatment instrument 1 is pulled out from the treatment instrument insertion channel 34, it is necessary to prevent the conductor cord 11 from being bent or the like. Here, in the conductor cord 11, the portion of the hollow wire 11 b that is extremely bent is applied, and a very strong bending force does not act on the conductive wire 11 a located on the base end side from the angle portion 32 b. For this reason, there is no possibility of bending wrinkles on the conductive wire 11a. Further, since the hollow wire 11b is composed of a metal wire having elasticity wound in a tightly wound coil shape, the hollow wire 11b is excellent in resilience to bending, and as described above, the angle portion 32b is extremely curved. Even when used under harsh conditions such as, there is no risk of bending wrinkles.

1 is an overall configuration diagram of a high-frequency treatment tool showing an embodiment of the present invention. It is a principal part expanded sectional view of FIG. It is an expanded sectional view of the tip part of a high frequency treatment instrument. It is a front view of the site | part of the flexible sheath of a high frequency treatment tool. It is explanatory drawing which shows the structure of a conductor cord. 1 is an external view showing a state in which a high-frequency treatment instrument showing an embodiment of the present invention is derived from a treatment instrument insertion channel of an endoscope. It is operation | movement explanatory drawing which shows the state which leads out the high frequency knife from the front-end | tip of a flexible sheath.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 High frequency treatment tool 2 Flexible sheath 3 Connection pipe 4 Handle member 10 Treatment tool main body 11 Conductor cord 11a Conductive wire 11b Hollow wire 13 High frequency knife 14 Rod-shaped electrode 20 Guide cylinder 21 Through-hole 22 Calling member 30 Endoscope 32 Insertion Part 32a Soft part 32b Angle part 32c Hard tip part 33 Treatment instrument introduction part 34 Treatment instrument insertion channel

Claims (3)

A treatment instrument provided with a flexible sheath that can be inserted into a treatment instrument insertion channel of an endoscope, and a high-frequency treatment member that is provided inside the flexible sheath and that applies a high-frequency current to the tip of a conductor cord A main body and a handle member connected to a proximal end portion of the flexible sheath, and the high-frequency treatment member protrudes and retracts from the flexible sheath by operating the handle member at a distal end of the flexible sheath. In a high-frequency treatment instrument in which a guide tube for guiding is inserted and fixed,
The conductor cord is connected to the high-frequency treatment member, and a hollow wire formed into a cylindrical shape by winding a metal wire in a tightly wound spiral shape, and a conductive wire inserted into and fixed to a proximal end portion of the hollow wire, Consisting of
The hollow wire is longer than at least the length from the distal end of the endoscope insertion portion to the proximal end portion of the angle portion when the flexible sheath is inserted into the treatment instrument insertion channel of the endoscope. A high-frequency treatment instrument characterized in that the base end portion of the conductive wire fixed to the hollow wire is connected to the handle member so as to be capable of being pushed and pulled. The high-frequency treatment tool according to claim 1, wherein the high-frequency treatment member is a high-frequency knife. The high-frequency treatment device according to claim 1 or 2, wherein the hollow wire is formed by forming a strip with a plurality of metal wire rods and winding the strip in a cylindrical shape.

Images