JP2008301861A - Forward projecting treatment tool for endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a forward projecting treatment tool for an endoscope which permits a tip treatment member to be kept in a maximally projected condition without requiring an assistant in performing treatment, permits the tip treatment member to be kept in a most evacuated condition without requiring an assistant in inserting and removing the treatment member into and out of the treatment tool insertion channel of the endoscope, and can be manufactured at a low cost. <P>SOLUTION: The forward projecting treatment tool is provided with a treatment member urging means 7 to urge the tip treatment member 3 in the direction of projecting forward of the tip of a flexible sheath 1, and an operating member locking means 20 capable of engaging and disengaging a slide operating member 14 with and from an operating portion body 11 with the tip treatment member 3 drawn to the tip side of the flexible sheath 1. The operating member locking means 20, a threadlike member 21 extended rearward of the slide operating member 14 and a thread winding mechanism 22-25 capable of winding the threadlike member 21 and releasing the threadlike member 21 from winding. <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 operating member locking means, the structure is complicated and the cost is increased.

  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 being required and can be manufactured at low cost.

  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. A treatment member urging means is provided and a distal treatment section In a state where the slide member is pulled toward the distal end side of the flexible sheath against the urging force of the treatment member urging means, the operation member locking means that can lock and release the slide operation member with respect to the operation portion main body is operated. A thread-like member that is provided in the operating portion and has an operating member locking means extending backward from the slide operating member in the operating portion main body, and a bobbin mechanism that is attached to the operating portion main body so as to wind up and release the thread-like member. And.

  The treatment member urging means may be built in the distal end portion of the flexible sheath, or a tension coil spring may be connected between the slide operation member and the thread-like member. In addition, the bobbin winding mechanism includes a bobbin shaft around which the thread-like member is wound, a bobbin operation knob for rotating the bobbin shaft around the axis, a rotation lock unit that can prevent and release the rotation of the bobbin shaft, and a bobbin winding You may provide the lock part urging means which urges | biases a rotation lock part in the state which blocks | prevents rotation of a axis | shaft.

  According to the present invention, the treatment member urging means for urging the distal treatment member in the direction protruding forward from the distal end of the flexible sheath is provided, so that an assistant is not required when performing the treatment. The sliding operation can be performed in a state in which the distal treatment member can be kept protruding to the maximum and the distal treatment member is pulled toward the distal end side of the flexible sheath against the urging force of the treatment member urging means. An operation member locking means capable of locking and releasing the member with respect to the operation portion main body is provided in the operation portion, and the operation member locking means extends in a backward direction from the slide operation member in the operation portion main body, and Since it is equipped with a thread winding mechanism that is attached to the operation unit main body so that the thread-like member can be wound and released, it can be manufactured at a low cost and can be inserted into and removed from the treatment instrument insertion channel of the endoscope. You can also keep that most retracted distal end treatment member without requiring assistants.

  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 projection type treatment instrument for a mirror, a treatment member urging means for urging the distal treatment member in a direction protruding forward from the distal end of the flexible sheath is provided, and the distal treatment member is attached to the treatment member urging means. Pull toward the distal end of the flexible sheath against force In this state, an operation member locking means that can lock and release the slide operation member with respect to the operation portion main body is provided in the operation portion, and the operation member lock means is provided in the operation portion main body from the slide operation member. A thread-like member extending rearward, and a thread winding mechanism attached to the operation unit main body so as to freely wind and release the thread-like member are provided.

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 configured as described above, as shown in FIGS. 3 and 6, a compression coil spring 7 (with a treatment member) is provided. The urging means) is arranged in contact with the rear end of the engagement protrusion 8a from the rear so as to constantly urge the distal treatment member 3 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. An operation member locking means 20 that can be locked and released with respect to the operation portion main body 11 is provided.

  As shown in FIG. 7, which is a plan view of the operation unit 10 and shows the operation member locking unit 20 in cross section, the operation member locking unit 20 is rearward from the slide operation member 14 in the slit 13 of the operation unit main body 11. An extending thread-like member 21 and a thread winding mechanism 22 to 25 attached to the operation unit main body 11 so that the thread-like member 21 can be wound and released are provided.

  The bobbin winding mechanisms 22 to 25 are rotatably attached to the operation unit main body 11 in a state of crossing the slit 13 and have a round bar-shaped bobbin winding shaft 22 around which the thread-like member 21 is wound, and the bobbin winding shaft 22 is rotated around the axis. A bobbin operation knob 23 that is directly connected to one end of the bobbin winding shaft 22 and protrudes laterally from the operation unit main body 11 so that the rotation of the bobbin winding shaft 22 can be prevented and released. For example, a hexagon nut-shaped rotation lock portion 24 and a compression coil that urges the bobbin shaft 22 in a direction in which the rotation lock portion 24 prevents the rotation of the bobbin shaft 22 (and thereby the rotation lock portion 24 is also urged). It is comprised with the spring 25 (lock part biasing means).

  The bobbin shaft 22 is supported in a support hole formed so as to penetrate the operation unit main body 11 so as to be rotatable about the axis and to be movable back and forth in the axial direction, and the outer wall surface of the operation unit main body 11 and the bobbin operation knob 23. It is urged by a compression coil spring 25 mounted between the inner end surface of the thread and the pin in the direction of projecting toward the spool operating knob 23 side.

  The hexagon nut-shaped rotation lock portion 24 is fixed to the other end portion of the bobbin shaft 22 that penetrates the operation portion main body 11 (the end portion on the opposite side to the bobbin operation knob 23). It is inserted into a hexagonal hole 16 formed to be recessed.

  Therefore, when the bobbin knob 23 is not operated at all, the rotation lock portion 24 is fitted in the hexagonal hole 16 as shown in FIG. It cannot be rotated even if it tries to do.

  Then, as shown by an arrow C in FIG. 8, when the spooling knob 23 is pushed in against the urging force of the compression coil spring 25, the engagement between the rotation lock portion 24 and the hexagonal hole 16 is released. As indicated by D, the thread winding operation knob 23 can be rotated to wind the thread-like member 21 around the thread winding shaft 22. Further, if tension is applied to the thread-like member 21, the thread winding shaft 22 is thereby rotated and the winding of the thread-like member 21 is released.

  When the operation of pushing the bobbin operation knob 23 is stopped, the rotation lock portion 24 is engaged with the hexagonal hole 16 by the urging force of the compression coil spring 25 and the rotation of the bobbin winding shaft 22 is prevented. The rotation lock portion 24 does not necessarily have a hexagonal nut shape, and may be a non-circular protruding piece or the like.

  Returning to FIG. 1, a tension coil spring 26 is connected between the slide operation member 14 and the thread-like member 21. More specifically, the tension coil spring 26 is connected between the connecting member 17 that protrudes rearward and fixed to the center position of the rear end of the wire connecting member 14 a constituting the slide operation member 14 and the tip of the thread-like member 21. In the normal use state, the thread-like member 21 is set in a slack state.

  Then, when the flexible sheath 1 is inserted into and removed from the treatment instrument insertion channel of the endoscope (not shown), as shown by arrows C and D in FIG. An operation of rotating the thread-like member 21 around the bobbin winding shaft 22 is performed.

  As a result, as shown in FIG. 9, the distal treatment member 3 is in the retracted state that is most drawn toward the distal end side of the flexible sheath 1, and if the operation of pushing the pinch operation knob 23 is stopped in this state, Thus, the rotation lock portion 24 is engaged with the hexagonal hole 16 and the state is maintained.

  When the thread-like member 21 is wound around the bobbin winding shaft 22, the tension coil spring 26 is stretched to some extent. The tension coil spring 26 is set so as to sufficiently compress the distal compression coil spring 7 in this state, and as a result, the distal treatment member 3 can stably maintain the retracted state.

  As a result, when the flexible sheath 1 is inserted into and removed from the treatment instrument insertion channel of the endoscope, the distal treatment member 3 is damaged, or conversely, the inner surface of the treatment instrument insertion channel is damaged by the distal treatment member 3. There is no fear.

  When the distal end of the flexible sheath 1 has passed through the treatment instrument insertion channel, the thread winding operation knob 23 is simply pushed in as shown by the arrow C in FIG. The state in which the coil 21 is wound is released by the urging force of the compression coil spring 7 and the tension coil spring 26, and the distal treatment member 3 protrudes most forward by the urging force of the compression coil spring 7 as shown in FIG. It becomes a state and the state is maintained. Therefore, even a single operation by an operator who operates the endoscope can be performed in a stable state.

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 plane fragmentary sectional view of the operation part of the front protrusion type treatment tool for endoscopes of the example of the present invention. It is a plane fragmentary sectional view of the operation part which shows the state which the operation member locking means of the front protrusion type treatment tool for endoscopes of the Example of this invention operated. 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 Tip treatment member 7 Compression coil spring (treatment member 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 Hexagonal hole 20 Operation member locking means 21 Threaded member 22 Bobbin axis (Pin winding mechanism)
23 Thread winding operation knob (Pin winding mechanism)
24 Rotation lock part
25 Compression coil spring (pipe winding mechanism) (locking portion biasing means)
26 Tension coil spring

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,
Treatment member urging means for urging 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 urging force of the treatment member urging means. In the state of being pulled toward the distal end side of the flexible sheath, an operation member locking means is provided in the operation portion, which can lock and release the slide operation member with respect to the operation portion main body,
The operation member locking means includes a thread-like member extending backward from the slide operation member in the operation portion main body, and a bobbin winding mechanism attached to the operation portion main body so as to be able to wind up and release the thread-like member. A forward-projecting treatment instrument for an endoscope, comprising:   The forward projecting treatment tool for an endoscope according to claim 1, wherein the treatment member urging means is built in a distal end portion of the flexible sheath.   The forward projecting treatment tool for an endoscope according to claim 1 or 2, wherein a tension coil spring is connected between the slide operation member and the thread member.   The bobbin mechanism includes a bobbin shaft around which the thread-like member is wound, a bobbin operation knob for rotating the bobbin shaft around an axis, a rotation lock portion that can prevent and release the rotation of the bobbin shaft, 4. The endoscope forward projecting treatment instrument according to claim 1, further comprising: a lock portion urging means that urges the rotation lock portion in a state of preventing rotation of the bobbin shaft.

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