JP2009207707A - Treatment tool for endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a highly practical treatment tool for an endoscope which regulates the rotation and projection of a distal end treatment member, is easily manufactured, and is successfully operated. <P>SOLUTION: The rear end of the distal end treatment member 2 is connected to the distal end of an operation wire 3 via a connection shaft 4. A plurality of grooves 5 recessed in a direction parallel to the axial line are arranged in parallel in the outer peripheral part of an area close to the distal end of the connection shaft 4, and the area is formed to have a spline shaft shape. An engagement member 7 to be engaged/disengaged with/from the grooves 5 of a spline shaft-shaped part is fixedly arranged in an inner peripheral part close to the distal end of a flexible sheath 1. The engagement member 7 is engaged with the groove 5 of the spline shaft-shaped part, so that the distal end treatment member 2 is regulated to rotate in a direction around the axial line of the flexible sheath 1, and at the same time, the distal end treatment member 2 is regulated to project from the distal end of the flexible sheath 1, to a certain degree or more. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to an endoscope treatment tool.

  In the case of an endoscopic treatment instrument that performs a treatment such as incising a living tissue with a high-frequency current through a treatment instrument insertion channel of an endoscope, such as a so-called endoscopic high-frequency incision instrument. A tip treatment member, which is an electrode, is disposed so as to protrude forward and backward from the distal end of the flexible sheath and to be rotatable about the axis of the flexible sheath, and is inserted into the flexible sheath so as to advance and retract in the axial direction. The distal treatment member protrudes and retracts from the distal end of the flexible sheath by advancing and retracting the arranged operation wire from the proximal end side, and the distal treatment member is rotated by rotating the operation wire in the direction around the axis from the proximal end side. Many are configured to rotate around the axis of the flexible sheath.

However, in order to prevent the distal treatment member from shaking when performing an incision treatment, a stopper that restricts the distal treatment member from protruding from the distal end of the flexible sheath more than a certain amount, and the distal treatment member is flexible. It is desirable to provide a rotation restricting mechanism that restricts rotation in the direction around the axis of the distal treatment member when the sheath protrudes from the distal end of the sheath (for example, Patent Document 1).
JP2004-261372

  Patent Document 1 allows the use of frictional resistance to restrict the rotation of the distal treatment member (FIG. 2 and the like) and the multi-slot groove that engages the protrusion provided near the distal end of the operation wire. There is described a member (FIG. 10 and the like) that is formed in the inner peripheral portion of the member disposed in the distal end of the flexible sheath in a direction parallel to the axis to restrict rotation.

  However, in the case where the rotation restriction is performed by using the frictional resistance described in FIG. 2 of Patent Document 1, the distal treatment member has an external force unless the operation wire is pushed in with a certain force or more. Since it will be in a rotating state, operability is not very good.

  In addition, as described in FIG. 10 of Patent Document 1 and the like, a multi-groove formed in the inner peripheral portion of a member disposed in the distal end of the flexible sheath in a direction parallel to the axis is often formed on the inner surface. It is cumbersome and unrealistic to manufacture parts with grooves.

  It is an object of the present invention to provide an endoscopic treatment tool that can perform rotation regulation and protrusion regulation of a distal treatment member, can be easily manufactured, has good operability, and is highly realistic. To do.

  In order to achieve the above object, the treatment instrument for an endoscope of the present invention has a distal treatment member disposed so as to be able to project forward and backward from the distal end of the flexible sheath and to be rotatable around the axis of the flexible sheath. The distal treatment member protrudes and retracts from the distal end of the flexible sheath by moving the manipulation wire inserted in the flexible sheath so as to be movable back and forth in the axial direction from the proximal end side. The distal treatment member is configured to rotate in the direction around the axis of the flexible sheath by rotating from the end side in the direction around the axis, and the tip treatment member protrudes from the distal end of the flexible sheath more than a certain amount. For an endoscope provided with a stopper for restricting rotation and a rotation restricting mechanism for restricting rotation of the distal treatment member around the axis of the flexible sheath when the distal treatment member protrudes from the distal end of the flexible sheath In treatment tools, advanced treatment The rear end of the material and the tip of the operation wire are connected via a connecting shaft, and a plurality of grooves recessed in a direction parallel to the axis are provided in the outer periphery of the region near the tip of the connecting shaft, and the region is splined. An engaging member that is formed in a shaft shape and engages / disengages with the groove of the spline shaft-shaped portion is fixedly disposed on the inner peripheral portion near the distal end of the flexible sheath, and the engaging member is formed in the groove of the spline shaft-shaped portion. By engaging, the distal treatment member is restricted from rotating in the direction around the axis of the flexible sheath, and at the same time, the distal treatment member is restricted from protruding more than a certain amount from the distal end of the flexible sheath. It is what I did.

  In addition, an inner cylinder in which the connecting shaft connects the distal treatment member and the operation wire, and an outer cylinder having a plurality of grooves formed in a slit shape in a region near the distal end in parallel with the axis. It may be fixedly formed.

  Alternatively, the rear end of the distal treatment member and the distal end of the operation wire are connected via a connecting shaft to form a wave-like portion that is concave and convex forward on the tip surface of the connecting shaft, and to engage and disengage from the wave-like portion. The joint member is fixedly disposed on the inner peripheral portion in the vicinity of the distal end of the flexible sheath, and the distal end treatment member rotates in the direction around the axis of the flexible sheath by engaging the engaging member with the corrugated portion. At the same time, the distal treatment member may be restricted from protruding beyond a certain amount from the distal end of the flexible sheath.

  The engaging member may be provided integrally with a rigid pipe-like member that is fixedly inscribed in the distal end portion of the flexible sheath. In that case, the engaging member may be a protruding member provided inwardly projecting on the inner peripheral portion of the pipe-shaped member, and the protruding member is parallel to the axis of the pipe-shaped member. It may be an elongated rod-shaped or wire-shaped member.

  According to the present invention, the rotation restricting mechanism can be processed and manufactured relatively easily, which is highly realistic, and at the same time that the distal treatment member is restricted from rotating in the direction around the axis of the flexible sheath. Since the distal treatment member is restricted from projecting from the distal end of the flexible sheath by a certain amount or more, the operations of the rotation restriction and the protrusion restriction are stable and the operability is good.

  The distal treatment member is disposed so as to be able to project forward and backward from the distal end of the flexible sheath and to be rotatable in the direction around the axis of the flexible sheath, and is inserted into the flexible sheath so as to be movable forward and backward in the axial direction. The distal treatment member protrudes and retracts from the distal end of the flexible sheath by operating the operation wire forward and backward from the proximal end side, and the distal treatment member is flexible by rotating the operation wire from the proximal end side in the direction around the axis. The stopper is configured to rotate around the axis of the sheath, the stopper for restricting the distal treatment member from projecting from the distal end of the flexible sheath to a certain extent, and the distal treatment member projects from the distal end of the flexible sheath. In a treatment instrument for an endoscope provided with a rotation restricting mechanism that restricts rotation of the flexible sheath in the direction around the axis of the flexible sheath, the rear end of the distal treatment member and the distal end of the operation wire are connected to the connecting shaft. Connected through A plurality of grooves recessed in the direction parallel to the axis are provided in the outer periphery of the region near the tip of the connecting shaft to form the region in the shape of a spline shaft, and the engagement engages with and disengages from the groove of the spline shaft-shaped portion. The member is fixedly disposed on the inner peripheral portion in the vicinity of the distal end of the flexible sheath, and the engaging member is engaged with the groove of the spline shaft-shaped portion, so that the distal treatment member is moved in the direction around the axis of the flexible sheath. At the same time that the rotation is restricted, the tip treatment member is restricted from protruding beyond a certain amount from the tip of the flexible sheath.

Embodiments of the present invention will be described below with reference to the drawings.
FIG. 3 is a side cross-sectional view of the distal end portion of the endoscope treatment tool, and FIG. 4 is a IV-IV cross-sectional view thereof. In this embodiment, the present invention is applied to a high-frequency incision tool for an endoscope.

  A flexible sheath 1 that is 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. Is about 2 mm in length and about 1-2 m in length.

  Inside the distal end of the flexible sheath 1, a conductive metal distal treatment member 2 formed in the shape of a hook whose side is bent sideways can be projected and retracted forward from the distal end of the flexible sheath 1. The flexible sheath 1 is disposed so as to be rotatable around the axis.

  An operation wire 3 made of a conductive metal is inserted in the flexible sheath 1 so as to be movable forward and backward in the axial direction and rotatable in the direction around the axial line, and is connected to the proximal end side of the flexible sheath 1. In the operation portion (not shown), the proximal end of the operation wire 3 can be moved forward and backward and rotated relative to the flexible sheath 1.

  The rear end of such a distal treatment member 2 and the distal end of the operation wire 3 are connected via a connecting shaft 4. FIG. 5 is an exploded view of the connecting portion. The connecting shaft 4 has a metal inner cylinder 4A for connecting the distal treatment member 2 and the operation wire 3, and a slit-like shape parallel to the axis in the region on the distal end side. A metal outer cylinder 4B having a plurality of (for example, about 8 to 20) grooves 5 that are notched is integrally fixed by welding or the like. In FIG. 5, the number of grooves 5 is less than that in the other drawings.

  The portion of the groove 5 is formed by cutting a region near the tip of the outer cylinder 4B into a strip shape. Therefore, it can be processed and manufactured very easily. Then, when both the cylinders 4A and 4B are integrated by welding or the like with the inner cylinder 4A being inserted into the outer cylinder 4B, the connecting shaft 4 is in the direction parallel to the axis on the outer peripheral portion of the region on the distal end side. It becomes the shape of a spline shaft shape in which a plurality of grooves 5 recessed in parallel are provided.

  In addition, without dividing the connecting shaft 4 into the inner cylinder 4A and the outer cylinder 4B, a plurality of grooves 5 (bottomed grooves) that are recessed in the direction parallel to the axis line are formed in parallel on the outer peripheral portion of the tip side region. Even when the region is formed in the shape of a spline shaft, the processing and manufacturing is very easy as compared to forming a groove on the inner peripheral surface.

  The inner cylinder 4A is a simple cylinder made of conductive metal, and a connecting protrusion 2a formed to protrude rearward from the rear end of the distal treatment member 2 is inserted into the distal end of the inner cylinder 4A and is inserted into the silver The operation wire 3 is fixed to the rear end of the inner cylinder 4A and fixed thereto by silver brazing or the like.

  Returning to FIG. 3 and FIG. 4, a hard metal pipe-like member 6 is fixedly attached in contact with the distal end portion of the flexible sheath 1. Reference numeral 6 a denotes an annular protrusion for fixing formed on the outer peripheral surface of the pipe-like member 6 so as to bite into the inner peripheral portion of the flexible sheath 1.

  On the inner peripheral portion of the pipe-shaped member 6, an elongated protrusion-shaped member 7 (engagement member) made of a metal rod-shaped or wire-shaped member or the like is inwardly elongated in a direction parallel to the axis of the pipe-shaped member 6. It is attached integrally in the state which protruded toward. As shown in FIG. 4, the protruding member 7 is formed to have a diameter that fits snugly so as not to be tight in the groove 5 of the connecting shaft 4.

  FIG. 6 shows the pipe-shaped member 6 and the protruding member 7 in an exploded state. The protruding member 7 is fixed to the inner peripheral surface of the pipe-shaped member 6 by, for example, laser welding. However, when at least one of the pipe-like member 6 and the protruding member 7 is made of a non-metal, it is fixed with a strong adhesive or the like.

  In the endoscope treatment tool configured as described above, when the operation wire 3 is pulled from the proximal end side, the distal treatment member 2 is placed in the distal end of the flexible sheath 1 as shown in FIG. As a result, the distal end of the distal treatment member 2 comes into contact with the distal end surface of the flexible sheath 1 to be stationary, and the endoscope is inserted into the treatment instrument insertion channel in this state.

  As shown in FIG. 7, when the operation wire 3 is slightly pushed from the proximal end side in the distal direction, the distal treatment member 2 protrudes forward from the distal end of the flexible sheath 1 to the intermediate portion, and the operation wire 3 is When the rotation operation is performed in the direction around the axis, the distal treatment member 2 is rotated following the rotation, and the direction is changed in the direction around the axis of the flexible sheath 1 so that the incision direction can be easily controlled.

  Then, when the operation wire 3 is further pushed in from the proximal end side toward the distal end, the protruding member 7 is fitted into the groove 5 as shown in FIG. 1 and FIG. 2 which is a II-II sectional view thereof. When the distal treatment member 2 cannot rotate in the direction around the axis of the flexible sheath 1 in a state of protruding from the distal end of the flexible sheath 1, and the protruding member 7 reaches the innermost position of the groove 5, The treatment member cannot protrude further from the distal end of the flexible sheath.

  Therefore, when the distal treatment member 2 protrudes from the distal end of the flexible sheath 1, a rotation restricting mechanism that restricts the rotation of the distal treatment member 2 in the direction around the axis of the flexible sheath 1 and the distal treatment member 2 are flexible. A stopper that restricts the protrusion of the sheath 1 from protruding from the tip of the sheath 1 is constituted by the groove 5 and the protruding member 7.

  When the distal treatment member 2 protrudes from the distal end of the flexible sheath 1 in this way, the distal treatment member 2 is in a very stable state without shaking with respect to the flexible sheath 1, so that the incision treatment is performed. Can be done smoothly.

  When the incision treatment is completed, the manipulation wire 3 is pulled from the proximal end side, whereby the distal treatment member 2 is accommodated in the flexible sheath 1 as shown in FIG. It can be pulled out from the treatment instrument insertion channel.

  FIG. 9 shows the distal end portion of the endoscope treatment tool according to the second embodiment of the present invention, and FIG. 10 shows a state in which the distal treatment member 2 protrudes forward. In this embodiment, in place of the groove 5 of the spline shaft-like portion of the first embodiment, a wave-like portion 5 ′ having irregularities toward the front is formed on the distal end surface of the connecting shaft 4. Other configurations are the same as those of the first embodiment described above, except that the engagement of the corrugated portion 5 'with the protruding member 7 is shallower than in the case of the groove 5 of the first embodiment. The same effect as the example can be obtained.

  In addition, this invention is not limited to the said Example, For example, you may apply this invention to the various treatment tools for endoscopes which do not use a high frequency current.

It is side surface sectional drawing of the front-end | tip part of the state which the front-end | tip treatment member protruded ahead in the treatment tool for endoscopes of 1st Example of this invention. It is II-II sectional drawing in FIG. 1 of the 1st Example of this invention. 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 IV-IV sectional drawing in FIG. 3 of 1st Example of this invention. It is a partial exploded perspective view of the treatment tool for endoscopes of the 1st example of the present invention. It is a partial exploded perspective view of the treatment tool for endoscopes of the 1st example of the present invention. It is side surface sectional drawing of the front-end | tip part in the state which the front-end | tip treatment member protruded to the middle in the endoscope treatment tool of 1st Example of this invention. It is side surface sectional drawing of the front-end | tip part in the state in which the front-end | tip treatment member was pulled back in the flexible sheath in the treatment tool for endoscopes of the 1st Example of this 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 state which the front-end | tip treatment member protruded ahead in the treatment tool for endoscopes of the 2nd Example of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Flexible sheath 2 End treatment member 3 Operation wire 4 Connection shaft 4A Inner cylinder 4B Outer cylinder 5 Groove 5 'Wave-like part 6 Pipe-shaped member 7 Projection-shaped member (engaging member)

Claims (6)

A distal treatment member is disposed so as to be able to project and retract forward from the distal end of the flexible sheath and to be rotatable about the axis of the flexible sheath, and is inserted into the flexible sheath so as to be movable forward and backward in the axial direction. The distal treatment member projects and retracts from the distal end of the flexible sheath by advancing and retracting the operated manipulation wire from the proximal end side, and the distal distal end is operated by rotating the manipulation wire in the direction around the axis from the proximal end side. A treatment member configured to rotate in a direction around the axis of the flexible sheath, and a stopper for restricting the distal treatment member from protruding beyond a certain amount from the distal end of the flexible sheath; and the distal treatment member An endoscopic treatment instrument provided with a rotation restricting mechanism for restricting rotation in the direction around the axis of the flexible sheath in a state of protruding from the distal end of the flexible sheath,
The rear end of the distal treatment member and the distal end of the operation wire are connected via a connecting shaft, and a plurality of grooves recessed in a direction parallel to the axis are provided in parallel on the outer periphery of the region near the tip of the connecting shaft. And the engaging member that engages and disengages with the groove of the spline shaft-like portion is fixedly disposed on the inner peripheral portion in the vicinity of the distal end of the flexible sheath. Is engaged with the groove of the spline shaft-shaped portion, so that the distal treatment member is restricted from rotating in the direction around the axis of the flexible sheath, and at the same time, the distal treatment member is flexible. A treatment instrument for an endoscope, characterized in that protruding beyond a certain amount from the distal end of the sheath is restricted.   The connecting shaft integrally includes an inner cylinder for connecting the distal treatment member and the operation wire, and an outer cylinder having a plurality of grooves formed in a slit shape in a region near the distal end in parallel with the axis. The endoscope treatment tool according to claim 1, wherein the treatment tool is fixed to the endoscope. A distal treatment member is disposed so as to be able to project and retract forward from the distal end of the flexible sheath and to be rotatable about the axis of the flexible sheath, and is inserted into the flexible sheath so as to be movable forward and backward in the axial direction. The distal treatment member projects and retracts from the distal end of the flexible sheath by advancing and retracting the operated manipulation wire from the proximal end side, and the distal distal end is operated by rotating the manipulation wire in the direction around the axis from the proximal end side. A treatment member configured to rotate in a direction around the axis of the flexible sheath, and a stopper for restricting the distal treatment member from protruding beyond a certain amount from the distal end of the flexible sheath; and the distal treatment member An endoscopic treatment instrument provided with a rotation restricting mechanism for restricting rotation in the direction around the axis of the flexible sheath in a state in which it protrudes from the distal end of the flexible sheath,
The rear end of the distal treatment member and the distal end of the operation wire are connected via a connecting shaft to form a wave-like portion that is concave and convex forward on the tip surface of the connecting shaft, and is engaged and disengaged from the wave-like portion. The engaging member to be fixed is disposed on the inner peripheral portion in the vicinity of the distal end of the flexible sheath, and the engaging member engages with the waved portion, so that the distal treatment member is attached to the flexible sheath. Endoscopic treatment characterized in that the distal treatment member is restricted from projecting more than a certain amount from the distal end of the flexible sheath at the same time that rotation in the direction around the axis is restricted. Ingredients.   4. The endoscope for an endoscope according to claim 1, 2 or 3, wherein the engaging member is integrally provided on a rigid pipe-like member that is fixedly inscribed in the distal end portion of the flexible sheath. Treatment tool.   The endoscope treatment tool according to claim 4, wherein the engaging member is a projecting member provided to project inward from an inner peripheral portion of the pipe-shaped member.   6. The endoscope treatment tool according to claim 5, wherein the protruding member is a rod-like or wire-like member elongated in a direction parallel to the axis of the pipe-like member.

Images