JP2008295609A - Forward-projecting treatment instrument for endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a forward-projecting treatment instrument for an endoscope, allowing an operator to retain a distal end treatment member in the projecting state to the maximum without needing an assistant in the treatment, to retain the distal end treatment member in the most retracted state without needing an assistant in inserting/taking out the instrument into/from a treatment instrument insertion channel of the endoscope, and having simple structure and excellent operability. <P>SOLUTION: The treatment instrument comprises an energization means 7 for energizing the distal end treatment member 3 in the direction of projection, and an operation member locking means for locking or unlocking a sliding operation member 14 into an operation part body 11 while the distal end treatment member 3 is in the retracted state. The operation member locking means comprises a sliding pawl 16 to slide together with the sliding operation member 14, and a leaf spring member 20 formed approximately in the J-shape. The leaf spring member 20 has a locking pawl 21 formed at the distal end of a longitudinal shaft part 23 to be engaged/disengaged with the sliding pawl 16, and a projecting piece 26 for pushing operation to displace the locking pawl 21 to a position not to be engaged with the sliding pawl 16. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to an endoscope front-projection type treatment instrument that is used through a treatment instrument insertion channel of an endoscope.

  Endoscopic treatment tools include those in which the distal treatment member disposed at the distal end portion of the flexible sheath is opened and closed like a hook by remote control, inflated or retracted, or moved forward and backward. However, the present invention relates to a forward-projecting treatment instrument for an endoscope that moves forward and backward.

Such a front-projection type treatment instrument for an endoscope generally has a distal treatment member disposed at the distal end portion of the flexible sheath inserted into and removed from the treatment instrument insertion channel of the endoscope in the flexible sheath. The inserted operation wire is configured to move forward and backward in the axial direction by projecting forward and backward from the distal end of the flexible sheath by operating in the axial direction at the operation portion connected to the proximal end of the flexible sheath. (For example, Patent Document 1).
JP2004-313537

  In the case of using the endoscope front-projection type treatment tool as described above, for example, the distal treatment member is projected forward from the distal end of the flexible sheath while applying a high-frequency current, and the surgeon Hold the flexible sheath on the proximal side of the endoscope and move it back and forth or perform bending operation of the endoscope.

  However, during such an operation, the distal treatment member may be pushed into the flexible sheath and retracted due to contact with the body tissue. Therefore, it is necessary for the assistant to keep pushing the operation wire from the proximal side so that the distal treatment member protrudes from the distal end of the flexible sheath to the maximum extent, which is a time-consuming work for two people. End up.

  In order to eliminate such an inconvenience, it is considered that a spring for urging the distal treatment member in a direction protruding forward from the distal end of the flexible sheath may be provided. However, simply adopting such a configuration, the distal treatment member protrudes to the maximum from the distal end of the flexible sheath even when the treatment instrument is inserted into and removed from the treatment instrument insertion channel of the endoscope. Therefore, there is a possibility that the distal treatment member may be damaged, or conversely, the inner surface of the treatment instrument insertion channel may be damaged by the distal treatment member.

  Therefore, an operation member locking means that can freely engage and disengage the slide operation member with respect to the operation portion main body in a state where the distal treatment member is pulled toward the distal end side of the flexible sheath against the biasing force of the spring. However, if a ratchet mechanism (for example, Japanese Utility Model Laid-Open No. 5-5105) or the like is provided as the operation member locking means, the structure is complicated and the operability is deteriorated.

  The present invention can maintain a state in which the distal treatment member protrudes to the maximum without requiring an assistant when performing a treatment, and the assistant can be inserted into and removed from the treatment instrument insertion channel of the endoscope. It is an object of the present invention to provide an endoscope front-projection type treatment instrument that can keep the distal treatment member in the most retracted state without necessity and that has a simple configuration and good operability.

  In order to achieve the above-described object, the front-projection type treatment instrument for an endoscope of the present invention includes a distal treatment member disposed at a distal end portion of a flexible sheath that is inserted into and removed from the treatment instrument insertion channel of the endoscope. The flexible operation wire inserted into the flexible sheath is moved forward and backward in the axial direction at the operation portion connected to the proximal end of the flexible sheath, thereby protruding forward from the distal end of the flexible sheath. A forward-projecting treatment instrument for an endoscope configured to advance and retreat, and an operation portion is connected to an operation portion main body connected to a proximal end of a flexible sheath and to a proximal end of an operation wire. In the endoscope front-projection type treatment instrument provided with a slide operation member that is slidably engaged with the operation portion main body, the distal treatment member is biased in a direction protruding forward from the distal end of the flexible sheath. Urging means is provided, and the distal treatment member is urged In a state in which the slide operation member is pulled toward the distal end side of the flexible sheath against the urging force of the step, an operation member locking means is provided in the operation unit so as to lock and release the slide operation member with respect to the operation unit main body. The operation member locking means is formed in a substantially J shape having a slide claw connected to the slide operation member so as to slide together with the slide operation member, a short shaft portion, a long shaft portion, and a bending return portion connecting them. In addition, the short shaft portion is locked to the operation portion main body, and a lock claw that engages with and disengages from the slide claw is formed at the tip of the long shaft portion so that the lock claw is displaced to a position that does not engage with the slide claw. And a leaf spring member in which a protrusion for pushing operation for elastically deforming the bending return portion is formed to protrude in the middle of the long shaft portion.

  The biasing means may be built in the distal end portion of the flexible sheath, and the leaf spring member is arranged in the operation portion main body, and only the pushing operation protrusion piece is operated among the portions of the leaf spring member. You may protrude from the surface of a part main body. Further, the slide claw may be arranged to extend rearward from the slide operation member in the operation unit main body.

  According to the present invention, since the biasing means for biasing the distal treatment member in a direction protruding forward from the distal end of the flexible sheath is provided, the distal treatment is performed without requiring an assistant when performing the treatment. A leaf spring formed in a substantially J-shape with a slide claw connected to the slide operation member so that the member can be kept protruding to the maximum and the operation member locking means slides together with the slide operation member A position where the short shaft portion of the leaf spring member is locked to the operation portion main body, a lock claw that engages with and disengages from the slide claw is formed at the tip of the long shaft portion, and the lock claw is not engaged with the slide claw The push-out operation protrusion for elastically deforming the bending back part so that it is displaced to the extent that it protrudes is formed in the middle of the long shaft part, so that it has a simple structure and good operability, and the endoscope treatment tool can be inserted. Insert / remove to channel It can be kept in a state of the most retracted distal end treatment member without requiring the assistant when.

  The distal treatment member disposed at the distal end portion of the flexible sheath that is inserted into and removed from the treatment instrument insertion channel of the endoscope transmits the flexible operation wire inserted into the flexible sheath to the flexible sheath. A forward-projecting treatment instrument for an endoscope configured to project forward and backward from the distal end of a flexible sheath by performing an advance / retreat operation in an axial direction at an operation unit coupled to a proximal end, The internal part is provided with an operation portion main body connected to the proximal end of the flexible sheath and a slide operation member connected to the proximal end of the operation wire and slidably engaged with the operation portion main body. In the front-projecting treatment instrument for a mirror, urging means for urging the distal treatment member in a direction projecting forward from the distal end of the flexible sheath is provided, and the distal treatment member resists the urging force of the urging means. In a state of being pulled toward the distal end of the flexible sheath In addition, an operation member locking means that can lock and release the slide operation member with respect to the operation section main body is provided in the operation section, and the operation member lock means is coupled to the slide operation member so as to slide with the slide operation member. Formed in a substantially J-shape having a slide claw, a short shaft portion, a long shaft portion, and a bending return portion connecting them, and the short shaft portion is locked to the operation portion main body, and the long shaft portion A locking claw that engages with and disengages from the slide claw is formed at the tip, and a pushing operation piece for elastically deforming the bending return portion so as to displace the lock claw to a position not engaged with the slide claw is provided in the middle of the long shaft portion. And a leaf spring member formed to project.

Embodiments of the present invention will be described below with reference to the drawings.
1 and 2 show the overall configuration of an endoscope front-projecting treatment instrument according to an embodiment of the present invention. FIG. 1 is a side sectional view and FIG. 2 is a perspective view.

  A flexible sheath 1 inserted into and removed from a treatment instrument insertion channel of an endoscope (not shown) is formed of an electrically insulating flexible tube such as a tetrafluoroethylene resin tube.

  A flexible conductive operation wire 2 is inserted through the entire length of the flexible sheath 1 so as to be movable back and forth in the axial direction, and the distal treatment member 3 made of a conductive rigid body is provided with the flexible sheath. 1 is connected to the tip. 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 to advance and retract from the proximal end side of the flexible sheath 1, and a proximal end cap 9 attached to the proximal end of the flexible sheath 1 is attached to the operation unit main body 11. For example, a luer lock engagement or the like is detachably connected to the receiving cap 19 attached to the tip.

  The receiving base 19 cannot be moved in the axial direction with respect to the operation unit main body 11 but is rotatably attached around the axial line. The receiving base 19 is held so as not to move, and the operation 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.

  An annular first finger hook 12 for engaging the operator's thumb is provided at the proximal end of the operation portion main body 11 formed in a round bar shape, and the round bar portion of the operation portion main body 11 has a constant width. The slit 13 is formed substantially over the entire length in a straight line in the axial direction.

  The slide operation member 14 that is slidably engaged with the operation portion main body 11 is a second member that engages the plate-shaped wire connection member 14a to which the proximal end 2a of the operation wire 2 is connected and fixed, and the index finger and middle finger of the operator. And a finger terminal 14b are integrally coupled, and a connection terminal 15 for connecting a high-frequency power cord (not shown) is arranged in a state of being electrically connected to the base end 2a of the operation wire 2. .

  The second finger hook 14b is formed with a through-hole having a circular cross-sectional shape into which the round bar-like portion of the operation portion main body 11 is loosely fitted, and the wire connecting member 14a is fitted into the slit 13 so as to be slidable in the axial direction. Yes.

  Therefore, when the slide operation member 14 is slid 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 is moved as indicated by the arrow B. It advances and retreats 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.

  FIG. 3 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. 4, a pair of upper and lower engaging projections 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. 5 illustrating a VV cross section in FIG. 3, an engagement protrusion 8a 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 engage with any of the engagement grooves 8b therein without rattling.

  The distal treatment member 3 is disposed so as to be movable back and forth 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 most protruding position at the front end 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 the distal end of the flexible sheath 1. However, it cannot rotate in the direction around the axis.

  Then, when the distal treatment member 3 is pulled by the operation wire 2 and retracted 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.

  In the distal end cap 5 attached to the distal end of the flexible sheath 1 of the endoscope treatment instrument thus configured, as shown in FIGS. 3 and 6, a compression coil spring 7 (biasing means) is provided. ) Is disposed in contact with the rear end of the engagement protrusion 8a from the rear in such a state that the distal treatment member 3 is always urged in a direction protruding forward from the distal end of the flexible sheath 1.

  Therefore, in a state where no operation part 10 is operated, as shown in FIG. 3, the distal treatment member 3 is in the most protruding state, and the rotation restricting means 8 is in the engaged state (that is, the engaging protrusion). 8a and the engaging groove 8b are engaged).

  Then, only when the operation wire 2 is pulled by the operation unit 10 by the slide operation member 14, as shown in FIG. 6, the distal treatment member 3 is retracted backward to engage the rotation restricting means 8. The state is released, and the distal treatment member 3 can rotate about the axis with respect to the flexible sheath 1.

  With such a configuration, the distal end of the flexible sheath 1 can be used as needed while the endoscope front-projecting treatment instrument of the present embodiment is being used through the treatment instrument insertion channel of the endoscope. The direction of the distal treatment member 3 with respect to can be adjusted.

  Then, by stopping the pulling operation of the slide operation member 14, as shown in FIG. 3, the distal treatment member 3 is protruded most forward from the distal end of the flexible sheath 1 by the urging force of the compression coil spring 7. Extruded.

  Then, since the rotation restricting means 8 is in an engaged state, the distal treatment member 3 is in a locked state where the distal end of the flexible sheath 1 cannot freely rotate in the direction around the axis, and this state is brought about by the urging force of the compression coil spring 7. Therefore, incision or the like can be performed safely and easily.

  Returning to FIGS. 1 and 2, in the operation unit 10, the slide operation member 14 is in a state where the distal treatment member 3 is pulled toward the distal end side of the flexible sheath 1 against the urging force of the compression coil spring 7. Operation member locking means 16 and 20 are provided which can be locked and unlocked with respect to the operation section main body 11.

  As shown in detail in FIG. 7 which is a perspective sectional view of the portion, the operating member locking means 16, 20 includes a slide claw 16 connected to the wire connecting member 14a so as to slide together with the slide operating member 14, A lock claw 21 that is engaged with and disengaged from the slide claw 16 is formed, and the plate spring member 20 is attached to the operation unit main body 11 side.

  The slide claw 16 is formed at the tip of an extending rod 17 that extends rearwardly from the wire connecting member 14a in the slit 13 of the operation unit main body 11, and the slide operating member 14 (that is, the wire connecting member 14a and Slide in the axial direction in the slit 13 together with the second finger hook 14b).

  The leaf spring member 20 is made of a leaf spring material made of a plastic material having elasticity such as polyacetal resin, for example, and has a substantially J-shape having a short shaft portion 22, a long shaft portion 23, and a bent back portion 24 connecting them. Formed in the slit 13. And the latching protrusion 25 formed by projecting laterally at the tip of the short shaft portion 22 is fitted into the locking hole 18 formed in the operation portion main body 11, so that the leaf spring member 20 is attached to the operation portion main body 11. It is locked.

  The lock claw 21 is formed at the tip of the long shaft portion 23 and is arranged in contact with the slide claw 16 between the inclined surfaces. As a result, when the extension rod 17 advances and retreats in the axial direction as indicated by the arrow C and the slide claw 16 moves with the extension rod 17, the lock claw 21 is pushed by the slide claw 16, thereby the long axis of the leaf spring member 20. The bent back portion 24 is elastically deformed so that the portion 23 swings as indicated by the arrow D.

  Further, at the middle position of the long shaft portion 23, there is a pushing operation protrusion 26 for elastically deforming the bending return portion 24 so as to displace the lock claw 21 to a side position where the lock claw 21 is not engaged with the slide claw 16. Is formed to protrude.

  As described above, the leaf spring member 20 is accommodated in the slit 13 in the operation unit main body 11, but only the projecting end of the push-in operation protruding piece 26 is from the side hole 19 formed in the operation unit main body 11. 11, when the pushing operation protrusion 26 is pushed as shown by an arrow E, the lock claw 21 is retracted to a position where it does not engage with the slide claw 16 as shown by an arrow D.

  FIG. 8 shows a state in which the slide claw 16 is engaged with the lock claw 21, and the lock claw pushed away by the slide claw 16 by pulling the slide operation member 14 backward as indicated by an arrow F. 21 is finally engaged with the slide claw 16 as shown in FIG. 8, and the distal treatment member 3 is pulled to the distal side of the flexible sheath 1 to be in a retracted state. This state is maintained even if the hand is released from the finger hook 14b.

  Therefore, when the flexible sheath 1 is inserted into and removed from the treatment instrument insertion channel of the endoscope (not shown), the distal treatment member 3 is damaged or conversely the distal treatment. There is no risk of damaging the inner surface of the treatment instrument insertion channel with the member 3.

  When the distal end of the flexible sheath 1 finishes passing through the treatment instrument insertion channel, the pushing claw 26 is pushed in as shown by the arrow E to engage the slide claw 16 and the lock claw 21. As a result, as shown in FIG. 1, the distal treatment member 3 is projected most forward by the urging force of the compression coil spring 7, and the state is maintained. Even a single operation by the surgeon can be performed in a stable state.

  As described above, the slide claw 16 and the leaf spring member 20 are simply provided, and the push operation protrusion 26 formed on the leaf spring member 20 is pushed only. It is possible to obtain such excellent operational effects.

It is side surface sectional drawing which shows the whole structure of the state which the front-end | tip treatment member of the front protrusion type treatment tool for endoscopes of the Example of this invention protruded. BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a perspective view showing an overall configuration of an endoscope front-projecting treatment tool according to an embodiment of the present invention. It is side surface sectional drawing of the front-end | tip part of the front protrusion type treatment tool for endoscopes of the Example of this invention. It is a perspective view of the front-end | tip treatment member of the front protrusion type treatment tool for endoscopes of the Example of this invention. It is VV sectional drawing in FIG. 3 of the front protrusion type treatment tool for endoscopes of the Example of this invention. It is side surface sectional drawing explaining operation | movement of the front-end | tip part of the front protrusion type treatment tool for endoscopes of the Example of this invention. It is a fragmentary perspective sectional view of the operation part of the forward projection type treatment tool for endoscopes of the example of the present invention. It is side surface sectional drawing which shows the whole structure of the state which the front-end | tip treatment member of the front protrusion type treatment tool for endoscopes of the Example of this invention evacuated.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Flexible sheath 2 Operation wire 3 End treatment member 7 Compression coil spring (biasing means)
DESCRIPTION OF SYMBOLS 10 Operation part 11 Operation part main body 13 Slit 14 Slide operation member 14a Wire connection member 14b 2nd finger hook 16 Slide claw (operation member locking means)
20 Leaf spring member (operating member locking means)
21 Locking Claw 22 Short Shaft Part 23 Long Shaft Part 24 Bending Back Part 26 Pushing Projection Piece

Claims (4)

The distal treatment member disposed at the distal end portion of the flexible sheath that is inserted into and removed from the treatment instrument insertion channel of the endoscope has the flexible operation wire inserted into the flexible sheath. An endoscope front-projecting treatment instrument configured to project forward and backward from the distal end of the flexible sheath by performing an advance / retreat operation in an axial direction at an operation unit connected to a proximal end of the sheath. And
The operation portion includes an operation portion main body connected to the proximal end of the flexible sheath, and a slide operation member connected to the proximal end of the operation wire and slidably engaged with the operation portion main body. In the endoscope front-projection type treatment instrument provided,
A biasing means for biasing the distal treatment member in a direction protruding forward from the distal end of the flexible sheath is provided, and the distal treatment member resists the biasing force of the biasing means. In the state of being pulled toward the distal end side of the sheath, an operation member locking means capable of locking and releasing the slide operation member with respect to the operation portion main body is provided in the operation portion,
The operation member locking means is
A slide claw coupled to the slide operation member to slide together with the slide operation member;
The short shaft portion is formed in a substantially J shape having a long shaft portion and a bending return portion connecting them, and the short shaft portion is locked to the operation portion main body, and the tip of the long shaft portion is A lock claw that is engaged with and disengaged from the slide claw is formed, and the projecting piece for pushing operation for elastically deforming the bending return portion so as to displace the lock claw to a position not engaged with the slide claw is the long shaft portion. A leaf spring member formed protruding in the middle of
A forward-projecting treatment instrument for an endoscope, comprising:   The forward-projecting treatment tool for an endoscope according to claim 1, wherein the biasing means is built in a distal end portion of the flexible sheath.   The inner part of Claim 1 or 2 with which the said leaf | plate spring member is arrange | positioned in the said operation part main body, and only the said pushing operation protrusion piece protrudes from the surface of the said operation part main body among each part of the said leaf | plate spring member. Endoscopic treatment tool for endoscope.   The endoscope front-projecting treatment instrument according to claim 1, 2, or 3, wherein the slide claw is arranged to extend rearward from the slide operation member in the operation portion main body.

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