JP2007319424A - Endoscopic treatment tool - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscopic treatment tool whose protrusive length of a tip treatment segment from a flexible sheath is made in a simple and highly practicable structure at a low cost so as to be stably adjusted and maintained at a predetermined length while used over a long time. <P>SOLUTION: An elastic friction drag applying member 4 is pressed into a region around the tip of the flexible sheath 1 with crushed and elastically deformed by an internal surface of the flexible sheath 1 and the outer surface of an operation wire 2 so that the friction drag caused acts respectively between the operation wire 2, the friction drag applying member 4, and the flexible sheath 1 in response to a movement of the operation wire 2. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to an endoscope treatment tool used through a treatment tool insertion channel of an endoscope.

  Endoscopic treatment instruments are generally provided with a distal treatment piece projecting forward and backward from the distal end of a flexible sheath that is inserted into and removed from the treatment instrument insertion channel of the endoscope so as to be movable forward and backward in the axial direction. The distal treatment piece is connected to the distal end of the operation wire inserted and arranged in the flexible sheath, and the projection length of the distal treatment piece from the distal end of the flexible sheath is changed by moving the manipulation wire in the axial direction. (For example, Patent Documents 1 and 2).

  However, if the tip treatment piece can be adjusted to a state where it protrudes from the tip of the flexible sheath to an appropriate length and the maintenance of the state is unstable, the tip treatment piece can be applied by the force received from the mucosal surface during use. The projecting length of the can change, and on the contrary, it can be dangerous.

Therefore, in the invention described in Patent Document 1, a screw member for adjusting the protruding length of the distal treatment piece is attached to the distal end portion of the flexible sheath. In the invention described in Patent Document 2 in which the flexible sheath is formed of a flexible tube, a wide portion larger than the inner diameter of the flexible tube is formed at the base of the distal treatment piece, and the wide portion is The protrusion length of the distal treatment piece can be stably maintained by the frictional resistance generated by expanding the flexible tube.
JP2002-1113016 JP-A-2005-270240

  However, as in the invention described in Patent Document 1, in the structure in which the screw member for adjusting the protruding length of the distal treatment piece is attached to the distal end portion of the flexible sheath, the treatment for the endoscope having a diameter of about 2 mm. Not only is the device complicated and impractical, but the length of the flexible sheath cannot be adjusted when the distal end of the flexible sheath is in the body cavity. There is an inconvenience that the treatment tool has to be pulled out from the treatment tool insertion channel.

  In addition, as in the invention described in Patent Document 2, when the flexible tube is pushed and expanded with a wide portion formed at the base of the distal treatment piece, not only the manufacturing cost of the distal treatment piece is high, Before being used many times, the cross-sectional shape of the flexible tube is permanently deformed in the direction in which it is pushed and widened by the wide part of the tip treatment piece, and the frictional resistance acting on the tip treatment piece is greatly reduced. There arises a disadvantage that the protruding length cannot be stably maintained.

  Therefore, the present invention stably adjusts the protruding length of the distal treatment piece from the distal end of the flexible sheath to an arbitrary length during use over a long period of time by a very simple and highly practical configuration at a low cost. An object of the present invention is to provide an endoscopic treatment tool that can be maintained.

  In order to achieve the above object, the treatment instrument for an endoscope according to the present invention has a distal treatment piece projecting forward and backward from the distal end of a flexible sheath inserted into and removed from the treatment instrument insertion channel of the endoscope. A distal treatment piece is connected to the distal end of an operation wire that is provided so as to be movable back and forth in the axial direction, and is inserted into the flexible sheath. By moving the operational wire forward and backward in the axial direction, the distal end of the flexible sheath is In an endoscope treatment tool configured to be able to change the protruding length of a distal treatment piece, an elastic frictional resistance imparting member having elasticity is formed by connecting an inner peripheral surface of a flexible sheath and an outer periphery of an operation wire. The elastic sheath is pressed and placed in the vicinity of the distal end of the flexible sheath so that it is elastically deformed. So that the frictional resistance generated between them acts One in which the.

  The distal treatment piece may be a conductive high-frequency electrode, and the operation wire may be a conductive wire that is electrically connected to the distal treatment piece, and the operation wire is formed by twisting a plurality of strands. The distal treatment piece may be formed by extending a part of the wire constituting the operation wire.

Further, the elastic frictional resistance imparting member may not be fixed in the flexible sheath, and the elastic frictional resistance imparting member may be a tubular member.
Further, the elastic frictional resistance imparting member may be a tube-shaped member having an outer diameter smaller than the inner diameter of the flexible sheath, and the elastic frictional resistance imparting member may be a solid rod-shaped member. Further, the elastic frictional resistance applying member may be an annular member surrounding the outer periphery of the operation wire.

  Further, a front stopper member may be provided for restricting the elastic frictional resistance imparting member from coming out of the distal end of the flexible sheath. In this case, the front stopper member is provided at the distal end portion of the flexible sheath. The front stopper member may be fixed to the distal end portion of the flexible sheath. The front stopper member may be formed by deforming the distal end portion of the flexible sheath.

  Alternatively, the front stopper member may be attached to the operation wire, and such a front stopper member is a pipe-shaped member having an outer diameter smaller than the inner diameter of the flexible sheath, and the operation wire is in the advance / retreat range. It is good to attach to the position which does not jump out from the front-end | tip of a flexible sheath in the state which moved to the most advanced position.

  Further, a rear stopper member may be provided for restricting the elastic frictional resistance imparting member from moving toward the rear position in the flexible sheath. In this case, the rear stopper member is attached to the operation wire. The rear stopper member may be a pipe-shaped member having an outer diameter smaller than the inner diameter of the flexible sheath.

  In addition, a surface treatment for increasing the frictional resistance between the elastic frictional resistance applying member and the inner peripheral surface of the flexible sheath is applied to an area where the outer peripheral surface of the elastic frictional resistance applying member is not in contact with the operation wire. May be.

  A plurality of elastic frictional resistance imparting members may be press-fitted and arranged in the vicinity of the distal end of the flexible sheath.

  According to the present invention, the elastic elastic frictional resistance imparting member having elasticity is crushed by the inner peripheral surface of the flexible sheath and the outer peripheral surface of the operation wire and is elastically deformed in the vicinity of the distal end of the flexible sheath. Since the frictional resistance generated between the operation wire, the elastic frictional resistance applying member, and the flexible sheath acts on the advancement and retraction operation of the operation wire, The protruding length of the distal treatment piece from the distal end can be stably adjusted and maintained at any length during use over a long period of time by a very simple and highly practical configuration at a low cost.

  A distal treatment piece projecting and retracting forward from the distal end of the flexible sheath inserted into and removed from the treatment instrument insertion channel of the endoscope is provided so as to be movable forward and backward in the axial direction, and is inserted and arranged in the flexible sheath. A distal treatment piece is connected to the distal end of the manipulated wire, and the projection length of the distal treatment piece from the distal end of the flexible sheath can be changed by advancing and retracting the manipulation wire in the axial direction. In the mirror treatment tool, the elastic elastic frictional resistance imparting member having elasticity is crushed by the inner peripheral surface of the flexible sheath and the outer peripheral surface of the operation wire and is elastically deformed in the vicinity of the distal end of the flexible sheath A frictional resistance generated between the operation wire, the elastic frictional resistance applying member, and the flexible sheath acts on the advancement / retraction operation of the operation wire.

Embodiments of the present invention will be described with reference to the drawings.
FIG. 3 shows the overall configuration of the endoscope treatment instrument according to the first embodiment of the present invention. For example, an ethylene tetrafluoride resin tube inserted into and removed from an endoscope treatment instrument insertion channel (not shown). In a flexible sheath 1 made of a flexible tube such as the above, an operation wire 2 made of a stranded wire of, for example, a stainless steel wire having electrical conductivity is inserted through the entire length so as to be able to advance and retract in the axial direction.

  At the distal end portion of the flexible sheath 1, a thin, straight rod-like high-frequency electrode having conductivity is advanced and retracted in the axial direction so as to project forward and backward from the distal end of the flexible sheath 1 as the distal treatment member 3. The distal end of the operation wire 2 is connected to the distal treatment member 3 so as to be freely arranged.

  Reference numeral 10 denotes an operation unit. A fixed finger 12 is formed at the rear end of the operation unit main body 11 connected to the proximal end of the flexible sheath 1, and the movable finger is slidably disposed on the operation unit main body 11. A proximal end of the operation wire 2 is connected and fixed to the hook 13, and a connection terminal 14 to which a high-frequency power cord (not shown) is connected is electrically connected to the operation wire 2 and disposed on the movable finger hook 13.

  With such a configuration, as indicated by an arrow A, as the movable finger hook 13 is slid in the operation unit 10, the operation wire 2 advances and retreats within the flexible sheath 1, as indicated by an arrow B. Further, the distal treatment member 3 advances and retreats at the distal end of the flexible sheath 1, and the protruding length of the distal treatment member 3 from the distal end of the flexible sheath 1 can be changed. Further, a high frequency current can be applied to the distal treatment member 3 from the high frequency power cord connected to the connection terminal 14 via the operation wire 2.

  The projection length of the distal treatment member 3 from the distal end of the flexible sheath is maintained at an arbitrary length near the distal end in the flexible sheath 1 of the endoscope treatment instrument thus configured. An elastic frictional resistance imparting member 4 is disposed.

  FIG. 1 shows the vicinity of the distal end of a flexible sheath 1 in which such a resilient frictional resistance imparting member 4 is arranged. The distal treatment member 3 is a stranded wire formed by twisting a plurality of strands. The operation wire 2 is formed of a portion in which a part of the strands such as one core wire is extended, and is formed seamlessly with respect to the operation wire 2.

  The elastic frictional resistance imparting member 4 pushes the tubular member between the inner peripheral surface of the flexible sheath 1 and the outer peripheral surface of the operation wire 2 as shown in FIG. The portion of the flexible sheath 1 that has been crushed and crushed by the operation wire 2 is elastically deformed into a depressed shape, and is press-fitted and disposed within the vicinity of the distal end of the flexible sheath 1.

  Such a resilient frictional resistance imparting member 4 is fixed to the flexible sheath 1 only by being disposed in a state where it is pushed into the flexible sheath 1 from the distal end side of the flexible sheath 1. Absent. Therefore, it can be manufactured very easily at low cost.

  The elastic frictional resistance imparting member 4 of this embodiment is formed of, for example, a tetrafluoroethylene resin tube having an outer diameter smaller than the inner diameter of the flexible sheath 1 and a thickness smaller than the thickness of the flexible sheath 1. Although the material itself is flexible, it is not rich in elasticity, but the elastically deformed part in the depressed state is rich in leaf spring elasticity that tries to return to its original shape, and its elasticity A repulsive force acts on the operation wire 2 and the flexible sheath 1.

  The flexible sheath 1 has a contact area between the elastic frictional resistance applying member 4 and the flexible sheath 1 that is significantly larger than the contact area between the operation wire 2 and the elastic frictional resistance providing member 4. When the operation wire 2 moves back and forth in the axial direction within the flexible sheath 1, the elastic frictional resistance applying member 4 is provided in the flexible sheath 1 as long as there is no catch between the operation wire 2 and the elastic frictional resistance applying member 4. Only the operation wire 2 moves forward and backward without moving, and the friction resistance between the operation wire 2 and the elastic frictional resistance imparting member 4 and the operation wire 2 and the flexible sheath with respect to the advance / retreat operation of the operation wire 2. Friction resistance between 1 and 1 acts.

  When the operation wire 2 and the elastic frictional resistance applying member 4 are caught or the like, the elastic frictional resistance applying member 4 is also moved by the advance / retreat operation of the operating wire 2 and the flexible sheath. There are cases in which it moves forward and backward within 1. In that case, the frictional resistance between the inner surface of the flexible sheath 1 and the operation wire 2 and the frictional resistance between the elastic frictional resistance applying member 4 and the flexible sheath 1 cause the operation wire 2 to move forward and backward. Act against.

  Such a frictional resistance is proportional to the magnitude of the repulsive force that the elastic frictional resistance imparting member 4 tries to restore to the original cross-sectional shape. A feeling of operation that the operation wire 2 is strongly pressed against the surface of the elastic frictional resistance imparting member 4 made of a good tetrafluoroethylene resin tube and that has a heavy and slimy resistance is obtained.

  As a result, the distal treatment member 3 can be adjusted to an arbitrary optimum length corresponding to the use situation at that time within the protruding range L shown in FIG. As long as the member 3 hits the body mucous membrane or the like, the protrusion length of the distal treatment member 3 from the distal end of the flexible sheath 1 does not change due to the frictional resistance that the operation wire 2 receives from the elastic frictional resistance imparting member 4. The protrusion length of the distal treatment member 3 can be arbitrarily adjusted by an operation from the operation unit 10.

  The distal end treatment member 3 is set so that the distal end of the distal treatment member 3 does not protrude from the distal end of the flexible sheath 1 when the manipulation wire 2 is pulled to the maximum from the operation unit 10 side. The flexible sheath 1 may be set so as to protrude slightly from the distal end.

  The magnitude of the frictional resistance acting on the forward / backward movement of the operation wire 2 is substantially proportional to the length of the elastic frictional resistance applying member 4. Therefore, by appropriately selecting the length of the elastic frictional resistance applying member 4 at the time of manufacture, it is possible to apply the most appropriate size of the frictional resistance according to the characteristics and purpose of use of the endoscope treatment tool. In addition, since the elastic frictional resistance applying member 4 is not fixed to the flexible sheath 1, the elastic frictional resistance applying member 4 can be replaced if necessary.

  Further, at the distal end of the flexible sheath 1 of this embodiment, as a front stopper member 5 for restricting the elastic frictional resistance imparting member 4 from coming out of the distal end of the flexible sheath 1, for example, PEEK (polyether) A round bar-shaped member made of ether ketone) is press-fitted and fixed, and the distal treatment member 3 passes loosely through a through hole formed at the axial position.

  Accordingly, the distal treatment member 3 protrudes forward from the axial position of the distal end of the flexible sheath 1, and the distal end surface of the operation wire 2 comes into contact with the rear end surface of the front stopper member 5, so that the distal treatment member 3 projects from the distal end of the flexible sheath 1. The maximum protrusion length of the distal treatment member 3 is regulated.

  When the elastic frictional resistance applying member 4 is moved toward the distal end side of the flexible sheath 1 by being dragged by the forward / backward movement of the operation wire 2, the elastic frictional resistance applying member 4 is moved to the front stopper member 5. The contact from the tip of the flexible sheath 1 is restricted. As in the second embodiment shown in FIG. 4, the front stopper member 5 is not provided as a single component, but the front end portion of the flexible sheath 1 is squeezed thinly by thermoforming or the like. It may be formed.

  FIG. 5 shows the vicinity of the distal end of the endoscope treatment tool according to the third embodiment of the present invention, and FIG. 6 shows a VI-VI cross section thereof. In this embodiment, a solid rod-like member whose material itself is elastic is used as the elastic frictional resistance imparting member 4 and can be formed of, for example, silicon resin or silicon rubber. Other configurations are the same as those of the first embodiment, and the same operational effects as those of the first embodiment can be obtained.

  FIG. 7 shows the vicinity of the distal end of the endoscope treatment instrument according to the fourth embodiment of the present invention. In the first embodiment, the elastic frictional resistance imparting member 4 comes out of the distal end of the flexible sheath 1. In place of the front stopper member 5 provided at the distal end of the flexible sheath 1 in order to restrict the movement, the distal end of the operation wire 2 (a boundary portion between the operation wire 2 and the distal treatment member 3) is used as the front stopper member 6. A pipe-shaped member is attached.

  The front stopper member 6 is formed of metal, hard plastic or the like having an outer diameter smaller than the inner diameter of the flexible sheath 1, and is firmly fixed to the tip of the operation wire 2 by soldering, bonding or caulking. . Other configurations are the same as those in the first embodiment.

  As shown in FIG. 8, the operation wire 2 has a length so that the front stopper member 6 does not jump out of the distal end of the flexible sheath 1 even when the operation wire 2 is pushed to the maximum from the operation unit 10 side. It has been adjusted. Therefore, even if the elastic frictional resistance imparting member 4 moves in the distal direction of the flexible sheath 1, it does not fall off from the distal end of the flexible sheath 1 by contacting the front stopper member 6.

  In the state in which the operation wire 2 is pulled to the maximum from the operation unit 10 side, the distal treatment member 3 completely sinks into the flexible sheath 1 as shown in FIG. Since the front stopper member 6 is attached, the elastic frictional resistance imparting member 4 does not move forward from the front stopper member 6.

  FIG. 10 shows the vicinity of the distal end of the endoscope treatment instrument of the fifth embodiment of the present invention. In addition to the front stopper member 6 of the fourth embodiment, the elastic frictional resistance imparting member 4 is flexible. The rear stopper member 7 is provided for restricting movement toward the rear in the sheath 1.

  The rear stopper member 7 is formed of a pipe-shaped member having an outer diameter smaller than the inner diameter of the flexible sheath 1, and is soldered to an intermediate portion of the operation wire 2 behind the elastic friction resistance applying member 4. It is firmly fixed by caulking or the like. Other configurations are the same as those in the fourth embodiment.

  As shown in FIG. 11, the operation wire 2 has a length so that the front stopper member 6 does not jump out of the distal end of the flexible sheath 1 even when the operation wire 2 is pushed to the maximum from the operation unit 10 side. It is set. Therefore, even if the elastic frictional resistance imparting member 4 moves in the distal direction of the flexible sheath 1, it does not fall off from the distal end of the flexible sheath 1 by contacting the front stopper member 6. Further, since the rear stopper member 7 is provided behind the elastic frictional resistance applying member 4, the elastic frictional resistance applying member 4 does not move rearward from the rear stopper member 7.

  In the state where the operation wire 2 is pulled to the maximum from the operation unit 10 side, the distal treatment member 3 completely sinks into the flexible sheath 1 as shown in FIG. Since the front stopper member 6 is attached, the elastic frictional resistance imparting member 4 does not move forward from the front stopper member 6. Further, since the rear stopper member 7 is provided behind the elastic frictional resistance applying member 4, the elastic frictional resistance applying member 4 does not move rearward from the rear stopper member 7.

  FIG. 13 shows the operation wire 2 and the elastic frictional resistance imparting member 4 of the sixth embodiment of the present invention, and the elastic frictional resistance imparting member 4 and the inner peripheral surface of the flexible sheath 1 are shown. A surface treatment 8 for increasing the frictional resistance is applied to a region of the outer peripheral surface of the elastic frictional resistance imparting member 4 that is not in contact with the operation wire 2.

  Such surface treatment 8 can be easily performed chemically using a strong acid or the like, and the elastic frictional resistance imparting member 4 is difficult to move relative to the flexible sheath 1. There is an advantage that the stoppers 5, 6, 7 for restricting the movement of 4 can be omitted.

  FIG. 14 shows a seventh embodiment of the present invention, in which the elastic frictional resistance imparting member 4 is formed of a rubber O-ring, and the other configurations are the same as those of the first embodiment. It is. As described above, the elastic frictional resistance imparting member 4 may be an annular member surrounding the outer periphery of the operation wire 2.

  FIG. 15 shows the entire configuration of the endoscope treatment tool according to the eighth embodiment of the present invention, and a plurality of elastic frictional resistance imparting members 4 are press-fitted and arranged in the vicinity of the distal end of the flexible sheath 1. Therefore, the lengths, material diameters, and the like of the two elastic frictional resistance imparting members 4 may be different.

  In addition, this invention is not limited to the said Example, For example, this invention is applicable also to the treatment tool for endoscopes which does not supply a high frequency current to the front treatment member 3. FIG.

It is side surface sectional drawing of the front-end | tip part of the treatment tool for endoscopes of 1st Example of this invention. It is II-II sectional drawing in FIG. 1 of the treatment tool for endoscopes of the 1st Example of this invention. 1 is a schematic view showing an overall configuration of an endoscope treatment tool according to a first embodiment of the present invention. It is side surface sectional drawing of the front-end | tip part of the treatment tool for endoscopes of the 2nd Example of this invention. It is side surface sectional drawing of the front-end | tip part of the treatment tool for endoscopes of the 3rd Example of this invention. It is VI-VI sectional drawing in FIG. 5 of the treatment tool for endoscopes of the 3rd Example of this invention. It is side surface sectional drawing of the front-end | tip part of the treatment tool for endoscopes of the 4th Example of this invention. It is side surface sectional drawing of the state which the front-end | tip treatment member of the front-end | tip part of the treatment tool for endoscopes of the 4th Example of this invention protruded to the maximum. It is side surface sectional drawing of the state to which the front-end | tip treatment member of the front-end | tip part of the treatment tool for endoscopes of the 4th Example of this invention was fully immersed. It is side surface sectional drawing of the front-end | tip part of the treatment tool for endoscopes of the 5th Example of this invention. It is side surface sectional drawing of the state which the front-end | tip treatment member of the front-end | tip part of the treatment tool for endoscopes of the 5th Example of this invention protruded to the maximum. It is side surface sectional drawing of the state which the front-end | tip treatment member of the front-end | tip part of the treatment tool for endoscopes of the 5th Example of this invention was fully immersed. It is a fragmentary perspective view of the elastic frictional resistance provision member and operation wire of the treatment tool for endoscopes of the 6th Example of the present invention. It is side surface sectional drawing of the elastic frictional resistance provision member part of the treatment tool for endoscopes of the 7th Example of this invention. It is the schematic which shows the whole structure of the treatment tool for endoscopes of the 8th Example of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Flexible sheath 2 Operation wire 3 End treatment member 4 Elastic frictional resistance provision member 5 Front stopper member 6 Front stopper member 7 Rear stopper member 8 Surface treatment

Claims (20)

A distal treatment piece projecting and retracting forward from the distal end of the flexible sheath inserted into and removed from the treatment instrument insertion channel of the endoscope is provided so as to be capable of moving forward and backward in the axial direction, and is inserted into the flexible sheath. The distal treatment piece is coupled to the distal end of the manipulated wire, and the protruding length of the distal treatment piece from the distal end of the flexible sheath can be changed by moving the operational wire in the axial direction. In the configured endoscopic treatment tool,
An elastic frictional resistance imparting member having elasticity is press-fitted into the vicinity of the distal end of the flexible sheath in a state where it is crushed and elastically deformed by the inner peripheral surface of the flexible sheath and the outer peripheral surface of the operation wire. An internal view characterized in that a frictional resistance generated between the operation wire, the elastic frictional resistance imparting member, and the flexible sheath acts on the forward / backward movement of the operation wire. Mirror treatment tool.   The treatment instrument for an endoscope according to claim 1, wherein the distal treatment piece is a conductive high-frequency electrode, and the operation wire is a conductive wire electrically connected to the distal treatment piece.   3. The operation wire is a stranded wire formed by twisting a plurality of strands, and the distal treatment piece is formed by extending a part of the strands constituting the operation wire. Endoscopic treatment tool.   The endoscopic treatment instrument according to claim 1, 2, or 3, wherein the elastic frictional resistance imparting member is not fixed in the flexible sheath.   The endoscopic treatment tool according to claim 1, 2, 3, or 4, wherein the elastic frictional resistance imparting member is a tube-shaped member.   The endoscope treatment tool according to claim 1, 2, 3, or 4, wherein the elastic frictional resistance imparting member is a tubular member having an outer diameter smaller than an inner diameter of the flexible sheath.   The endoscope treatment tool according to claim 1, 2, 3, or 4, wherein the elastic frictional resistance imparting member is a solid rod-shaped member.   The endoscope treatment instrument according to claim 1, 2, 3, or 4, wherein the elastic frictional resistance applying member is an annular member surrounding an outer periphery of the operation wire.   The endoscopic treatment instrument according to any one of claims 1 to 8, wherein a front stopper member is provided for restricting the elastic frictional resistance applying member from slipping out from the distal end of the flexible sheath. .   The endoscope treatment tool according to claim 9, wherein the front stopper member is provided at a distal end portion of the flexible sheath.   The treatment instrument for an endoscope according to claim 10, wherein the front stopper member is fixed to a distal end portion of the flexible sheath.   The treatment instrument for an endoscope according to claim 10, wherein the front stopper member is formed by deforming a distal end portion of the flexible sheath.   The endoscope treatment tool according to claim 9, wherein the front stopper member is attached to the operation wire.   The endoscopic treatment tool according to claim 13, wherein the front stopper member is a pipe-shaped member having an outer diameter smaller than the inner diameter of the flexible sheath.   The internal view according to claim 13 or 14, wherein the front stopper member is attached at a position where the front end of the flexible sheath does not protrude when the operation wire is moved to the most advanced position of the advance / retreat range. Mirror treatment tool.   The inner member according to any one of claims 1 to 15, further comprising a rear stopper member for restricting the elastic frictional resistance imparting member from moving toward a rear position in the flexible sheath. Endoscopic treatment tool.   The endoscope treatment instrument according to claim 16, wherein the rear stopper member is attached to the operation wire.   The endoscopic treatment tool according to claim 17, wherein the rear stopper member is a pipe-shaped member having an outer diameter smaller than the inner diameter of the flexible sheath.   A region where the surface treatment for increasing the frictional resistance between the elastic frictional resistance applying member and the inner peripheral surface of the flexible sheath is not in contact with the operation wire on the outer peripheral surface of the elastic frictional resistance applying member The treatment instrument for an endoscope according to any one of claims 1 to 8, which is applied to the endoscope. The endoscopic treatment instrument according to any one of claims 1 to 19, wherein a plurality of the elastic frictional resistance imparting members are press-fitted and arranged in the vicinity of the distal end of the flexible sheath.

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