JP2008253352A - Treatment tool for endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a treatment tool for an endoscope with high operability, allowing an operator to easily perform the accurate treatment operation without feeling fatigue because the direction of a distal treatment member is retained without applying the operation force to an operation wire after the direction of the treatment member is correctly set. <P>SOLUTION: The treatment tool for the endoscope has rotation restraining means on the distal end side and the distal end treatment member 3 side of a flexible sheath 1. The rotation restraining means is in the engaged state to restrain the distal end treatment member 3 from rotating in the axial direction relative to the distal end of the flexible sheath 1 in only a part of the range of retraction of the distal end treatment member 3 relative to the distal end of the flexible sheath 1. The treatment tool also has an energizing means 17 in an operating part 10 for energizing the distal end treatment member 3 in the axial direction toward the location where the rotation restraining means is in the engaged state. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to an endoscope treatment tool.

  In an endoscopic treatment instrument or the like for incising / removing a mucous membrane in a body with a high-frequency current, a conductive operation wire is inserted and disposed in a flexible sheath so as to be movable back and forth in the axial direction. The distal treatment member connected to the distal end of the operation wire is advanced and retracted in the axial direction with respect to the distal end of the flexible sheath by advancing and retracting from the end side. Further, the operation wire is moved from the proximal end side to the axial line. Some of the distal treatment members are configured to rotate in the direction around the axis with respect to the distal end of the flexible sheath by rotating around, thereby improving sniperability.

  However, if the tip treatment member is simply configured to rotate in the direction around the axis relative to the tip of the flexible sheath, the tip treatment member will shake when incising / removing the mucosa in the body. Incisions / resections may not be possible on the street.

Therefore, the rotation restricting means that is in an engagement state that restricts the distal treatment member from rotating in the direction around the axis relative to the distal end of the flexible sheath only in a part of the advance / retreat range of the distal treatment member relative to the distal end of the flexible sheath. Is provided on the distal end side and distal treatment member side of the flexible sheath so that the distal treatment member cannot be rotated around the axis with respect to the distal end of the flexible sheath when performing incision / resection (For example, Patent Document 1).
JP2004-261372

  However, in the invention described in Patent Document 1, in order to maintain the state in which the rotation restricting means is engaged when performing incision / resection, the operation unit connected to the proximal end of the flexible sheath is manually operated. Therefore, it is necessary to keep the operation wire pushed in.

  Then, if the pushing operation with respect to the operation wire is loosened, the rotation restricting means is disengaged and the distal treatment member rotates freely, so that the incision / resection cannot be performed in an appropriate direction. Until the excision was completed, the force of the push-in operation could not be completely removed, and the operability such as the finger getting tired was bad.

  According to the present invention, after the distal treatment member is properly set, the orientation is maintained without applying an operation force to the operation wire, and an operation capable of easily performing an accurate treatment operation without fatigue. An object of the present invention is to provide a good endoscopic treatment tool.

  In order to achieve the above object, an endoscope treatment tool according to the present invention is connected to the proximal end of a flexible sheath by inserting an operation wire into the flexible sheath so as to be movable forward and backward in the axial direction. By operating the operation wire forward and backward with the operation unit, the distal treatment member connected to the distal end of the operation wire advances and retracts in the axial direction with respect to the distal end of the flexible sheath, and the operation wire is rotated around the axis from the proximal end side. The distal treatment member is configured to rotate in the axial direction relative to the distal end of the flexible sheath by operating, and the distal treatment member is only in a part of the advance / retreat range of the distal treatment member relative to the distal end of the flexible sheath. For the endoscope in which the rotation restricting means for engaging with the distal end of the flexible sheath is provided on the distal end side of the flexible sheath and the distal treatment member side. On the treatment instrument, It means in which biasing means for biasing the distal end treatment member toward a position where the engagement in the axial direction is provided on the operation unit.

  The urging means may be a spring that urges the operation wire in a direction to push the operation wire into the flexible sheath from the operation unit side, or a direction in which the operation wire is pulled from the flexible sheath to the operation unit side. It may be a spring urging the spring.

  According to the present invention, the engagement state restricts the rotation of the distal treatment member relative to the distal end of the flexible sheath in the direction around the axis only in a part of the advance / retreat range of the distal treatment member relative to the distal end of the flexible sheath. In the endoscope treatment instrument in which the rotation restricting means is provided on the distal end side and the distal treatment member side of the flexible sheath, the distal treatment member is moved in the axial direction toward the position where the rotation restricting means is engaged. Since the biasing means for biasing is provided in the operating portion, the orientation of the distal treatment member is maintained without applying operating force to the operating wire after the orientation of the distal treatment member is properly set. The treatment operation can be easily performed without fatigue, and very excellent operability can be obtained.

  An operation wire is inserted and disposed in the flexible sheath so as to be movable back and forth in the axial direction, and the operation wire is advanced and retracted by an operation unit connected to the proximal end of the flexible sheath, thereby being connected to the distal end of the operation wire. The distal end treatment member advances and retracts in the axial direction with respect to the distal end of the flexible sheath, and the distal treatment member rotates about the axis with respect to the distal end of the flexible sheath by rotating the operation wire about the axis from the proximal end side. The distal treatment member is restricted from rotating in the axial direction relative to the distal end of the flexible sheath only in a part of the advance / retreat range of the distal treatment member relative to the distal end of the flexible sheath. In the endoscope treatment instrument in which the rotation restricting means to be engaged is provided on the distal end side and the distal treatment member side of the flexible sheath, the distal treatment toward the position where the rotation restricting means is engaged. Axis member Biasing means for biasing in a direction which is provided in the operation unit.

Embodiments of the present invention will be described below with reference to the drawings.
FIG. 1 shows an overall configuration of an endoscope treatment instrument. A flexible sheath 1 inserted into and removed from an endoscope treatment instrument insertion channel (not shown) is, for example, a tetrafluoroethylene resin tube or the like. Such an electrically insulating flexible tube is formed.

  In the flexible sheath 1, a conductive operation wire 2 is inserted and arranged over the entire length so as to be movable back and forth in the axial direction, and a distal treatment member 3 made of a conductive rigid body is connected to the distal end of the flexible sheath 1. Has been. Although the distal treatment member 3 of this embodiment is formed in a hook shape, it may have other shapes.

  Reference numeral 10 denotes an operation unit for operating the operation wire 2 forward and backward from the proximal end side of the flexible sheath 1, and a proximal end cap 12 attached to the proximal end of the flexible sheath 1 is attached to the operation unit main body 11. It is detachably connected to the receiving cap 13 attached to the tip by, for example, luer lock engagement.

  The receiving base 13 cannot be moved in the axial direction with respect to the operation unit main body 11 but is rotatably mounted around the axial line. The holding base 13 is held so as not to move, and the operating unit main body 11 is moved around the axis. When rotated, the operation wire 2 rotates around the axis within the flexible sheath 1, and the distal treatment member 3 rotates around the axis at the distal end portion of the flexible sheath 1.

  The slide operation member 14 that is slidably engaged with the operation unit main body 11 includes a slide member 14a to which the proximal end 2a of the operation wire 2 is coupled and a finger hook 14b for engaging the operator's finger. A connection terminal 15 for connecting a high-frequency power cord (not shown) is arranged in a state of being electrically connected to the operation wire 2.

  As a result, by sliding the slide operation member 14 as indicated by the arrow A, the operation wire 2 advances and retreats in the axial direction within the flexible sheath 1, and the distal treatment member 3 as indicated by the arrow B. Moves forward and backward in the axial direction in front of the distal end of the flexible sheath 1. Further, by connecting a high frequency power cord to the connection terminal 15, a high frequency current can be applied to the distal treatment member 3 via the operation wire 2.

  In such an operation unit 10, a compression coil spring 17 (biasing means) that urges the operation wire 2 in the direction in which the operation wire 2 is pushed into the flexible sheath 1 from the operation unit 10 side is provided at the proximal end of the operation unit main body 11. This is mounted between the slide operation member 14 and the portion (right end portion in FIG. 1). Reference numeral 18 denotes a connecting rod that connects the space between the slide operation member 14 and the compression coil spring 17.

  Therefore, in a state where the operation unit 10 is not operated, the operation wire 2 is pushed from the operation unit 10 side to the flexible sheath 1 side by the urging force of the compression coil spring 17, and the distal treatment member 3 protrudes forward. It will be in the state.

  When the slide operation member 14 is pulled in the hand direction against the urging force of the compression coil spring 17, the operation wire 2 is pulled toward the operation unit 10 and the distal treatment member 3 is moved into the flexible sheath 1. If it is moved backward and the application of the force to operate the slide operation member 14 is stopped, the operation wire 2 is pushed from the operation unit 10 side to the flexible sheath 1 side by the urging force of the compression coil spring 17. The distal treatment member 3 returns to the state of protruding forward.

  FIG. 2 shows the vicinity of the distal end of the flexible sheath 1, and the operation wire 2 and the distal treatment member 3 are mechanically and electrically connected by a metal connection pipe 4. A substantially cylindrical distal end cap 5 is fixedly attached to the most distal end portion of the flexible sheath 1, and a retaining cylinder 6 having an inner diameter smaller than the distal end opening of the distal end cap 5 is the most distal end portion of the distal end base 5. It is fixed to.

  As shown in FIG. 3, a pair of upper and lower engaging protrusions 8 a are formed on the base portion of the distal treatment member 3 located in the distal end cap 5 so as to protrude laterally. Further, as shown in FIG. 4 illustrating the IV-IV cross section in FIG. 2, an engaging protrusion 8 a formed on the distal treatment member 3 moves in the axial direction on the inner peripheral portion of the distal end of the retaining cylinder 6. Thus, radial engagement grooves 8b that are engaged and disengaged are formed at equal intervals over the entire circumference.

  In this embodiment, twelve engagement grooves 8b are formed at intervals of 30 °, and the engagement protrusions 8a can be engaged with any of the engagement grooves 8b therein without rattling. In addition, the direction at the time of fixing the rotation direction of the distal treatment member 3 to be described below can be regulated with finer angular intervals as the interval between the engagement grooves 8b is narrower.

  The distal treatment member 3 is disposed so as to be movable forward and backward in the axial direction with respect to the distal end of the flexible sheath 1 (and therefore also with respect to the distal end cap 5 and the retaining cylinder 6), as shown in FIG. Further, when the engagement protrusion 8a comes into contact with the small diameter portion of the distal end of the retaining cylinder 6 from the rear, further advancement of the distal treatment member 3 is restricted.

  Therefore, when the distal treatment member 3 is at the front end position of the advance / retreat range, the engagement protrusion 8 a is engaged with the engagement groove 8 b, and the distal treatment member 3 is axial with respect to the distal end of the flexible sheath 1. Cannot rotate in the surrounding direction.

  Then, when the distal treatment member 3 is pulled by the operation wire 2 and moves rearward (that is, in the direction within the flexible sheath 1), the engagement between the engagement protrusion 8a and the engagement groove 8b as shown in FIG. As a result, the distal end treatment member 3 can freely rotate in the direction around the axis with respect to the distal end of the flexible sheath 1, and the operation unit 10 is moved around the axis with respect to the flexible sheath 1 on the hand side. By rotating, the distal treatment member 3 rotates around the axis at the distal end of the flexible sheath 1.

  With such a configuration, when the operation unit 10 is not operated at all, the operation wire 2 is moved from the operation unit 10 side to the flexible sheath 1 side by the urging force of the compression coil spring 17 as shown in FIG. Since it is pushed in, as shown in FIG. 2, the rotation restricting means 8 is in an engaged state (that is, a state in which the engaging protrusion 8a and the engaging groove 8b are engaged).

  Then, only when the operation wire 2 is pulled by the operation portion 10 by the slide operation member 14, the engagement state of the rotation restricting means 8 is released as shown in FIG. It becomes possible to rotate in the direction around the axis with respect to the flexible sheath 1.

  Therefore, when using the endoscope treatment tool of this embodiment, when the distal treatment member 3 is guided to face the target affected area or the like, the operation portion 10 resists the urging force of the compression coil spring 17. The slide operation member 14 is pulled, and in this state, the receiving base 13 is held so as not to move, and the operation portion main body 11 is rotated around the axis together with the slide operation member 14.

  Then, as shown in FIG. 5, the distal treatment member 3 rotates in the direction around the axis at the distal end of the flexible sheath 1, so that the distal treatment member 3 is in the most suitable orientation for treating the affected area. When the pulling operation of the slide operation member 14 is stopped, the operation wire 2 is pushed forward by the urging force of the compression coil spring 17, and the rotation restricting means 8 is engaged as shown in FIG. 3 is in a state in which it cannot rotate in the direction around the axis at the tip of the flexible sheath 1.

  At this time, the engaging protrusion 8a engages with the closest engaging groove 8b among the twelve engaging grooves 8b formed at intervals of 30 °, and may rotate up to about 15 °. The deflection angle of the distal treatment member 3 to that extent is generally allowed.

  Thus, when the distal treatment member 3 is fixed at the distal end of the flexible sheath 1 and a high-frequency current is subsequently applied to the distal treatment member 3 to perform a mucosal incision treatment or the like, Since the distal treatment member 3 is fixed in the direction around the axis at the distal end of the flexible sheath 1 without any operation of the portion 10, an incision treatment or the like can be performed safely and easily.

  6 and 7 show the entire configuration and the vicinity of the distal end of the endoscope treatment tool according to the second embodiment of the present invention. As shown in FIG. 7 is attached between the receiving base 13 and the slide operation member 14 so as to be biased in the direction of pulling the flexible sheath 1 from the flexible sheath 1 toward the operation portion 10 side. As shown in FIG. An engagement groove 8b is provided at the rear end position of the tip cap 5 so that the rotation restricting means 8 is engaged when it is at the rear end position in the axial movement range. Even if comprised in this way, the effect similar to the above-mentioned 1st Example can be acquired.

  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 use a high frequency current.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is an overall configuration diagram 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 vicinity of the treatment tool for endoscopes of 1st Example of this invention. It is a perspective view of the front-end | tip treatment member of the treatment tool for endoscopes of 1st Example of this invention. It is IV-IV sectional drawing in FIG. 2 of the treatment tool for endoscopes of the 1st Example of this invention. It is side surface sectional drawing of the front-end | tip vicinity of the state by which the operation wire was pulled by the operation part side in the treatment tool for endoscopes of 1st Example of this invention. It is a whole block diagram of the treatment tool for endoscopes of the 2nd Example of this invention. It is side surface sectional drawing of the front-end | tip vicinity of the treatment tool for endoscopes of 2nd Example of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Flexible sheath 2 Operation wire 3 Tip treatment member 8 Rotation restriction means 8a Engagement protrusion 8b Engagement groove 10 Operation part 13 Receiving cap 14 Slide operation member 17 Compression coil spring (biasing means)

Claims (3)

An operation wire is inserted into the flexible sheath so as to be movable back and forth in the axial direction, and the operation wire is advanced and retracted by an operation unit connected to the proximal end of the flexible sheath, whereby the distal end of the operation wire The distal treatment member connected to the distal end of the flexible sheath advances and retreats in the axial direction with respect to the distal end of the flexible sheath, and the distal treatment member is rotated about the axial line from the proximal end side, whereby the distal treatment member is moved to the flexible sheath. The distal treatment member is configured to rotate at the distal end of the flexible sheath only in a part of the advance / retreat range of the distal treatment member relative to the distal end of the flexible sheath. An endoscopic treatment instrument in which rotation restricting means that is in an engaged state for restricting rotation in the direction around the axis is provided on the distal end side of the flexible sheath and the distal treatment member side.
An endoscopic treatment instrument, wherein an urging means for urging the distal treatment member in an axial direction toward a position where the rotation restricting means is engaged is provided in the operation portion.   The endoscope treatment tool according to claim 1, wherein the urging means is a spring that urges the operation wire in a direction in which the operation wire is pushed into the flexible sheath from the operation portion side.   The endoscope treatment tool according to claim 1, wherein the urging means is a spring that urges the operation wire in a direction of pulling the operation wire from the flexible sheath toward the operation portion.

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