JP2010075442A - Treatment device for endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a treatment device for an endoscope which is excellent in operability capable of rotating the leading end treatment member provided at the distal end of a flexible sheath in the axial direction by easy operation without requiring operation for rotating the whole of an operation portion on the hand side. <P>SOLUTION: In the treatment device for the endoscope which is constituted so that the leading end treatment member 3 connected to the leading end of an operation wire 4(4A) is rotated in a the direction centering around the axial direction at the leading end of the flexible sheath 1 by relatively rotating the operation wire 4(4A) in the direction centering around the axial direction with respect to the flexible sheath 1 on the distal end side of the flexible sheath 1, a rotary operation means 14, which performs operation for independently rotating the operation wire 4(4A) in the axial direction relative to another member, is provided at a slide operation member 12. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to an endoscope treatment tool.

  In general, an endoscopic treatment tool has an operation wire inserted and disposed in a flexible sheath so as to be movable back and forth in the axial direction, and a distal treatment member connected to the distal end of the operation wire is disposed at the distal end portion of the flexible sheath. A slide operation member for advancing and retracting the operation wire in the axial direction is provided at the operation unit connected to the proximal end of the flexible sheath.

Then, the base end of the flexible sheath is rotatably connected to the operation part in the direction around the axis, and the entire operation part is rotated in the direction around the axis with respect to the base end of the flexible sheath. There are many cases in which the operation wire rotates in the flexible sheath so that the direction of the distal treatment member can be arbitrarily changed from the hand side (for example, Patent Document 1).
JP2007-215896

  However, since the operator of the endoscope treatment tool usually passes a finger through the slide operation member provided in the operation unit, in order to rotate the entire operation unit with respect to the proximal end of the flexible sheath, Troublesome operations such as removing the finger and holding the entire operation unit are required.

  In particular, in the case of a high-frequency treatment instrument in which the distal treatment member is a high-frequency electrode, when the entire operation unit is rotated, the high-frequency power cord extending from the operation unit is wrapped around the operation unit, and the cord It may be necessary to redo the connection, which may require extremely complicated work.

  According to the present invention, the distal treatment member provided at the distal end of the flexible sheath can be rotated in the direction around the axis by an easy operation without requiring an operation for rotating the entire operation unit on the hand side. An object of the present invention is to provide an endoscopic treatment tool with excellent operability.

  In order to achieve the above object, an endoscope treatment instrument according to the present invention has an operation wire inserted and disposed in a flexible sheath so as to be movable forward and backward in the axial direction and rotatable in a direction around the axis. A distal treatment member connected to the distal end is arranged at the distal end portion of the flexible sheath, and a slide operation member for moving the operation wire forward and backward in the axial direction is provided in the operation portion connected to the proximal end of the flexible sheath. At the same time, on the proximal end side of the flexible sheath, the distal treatment member is rotated in the direction around the axis at the distal end of the flexible sheath by rotating the operation wire relative to the flexible sheath in the direction around the axis. In the endoscope treatment tool configured as described above, the slide operation member is provided with a rotation operation means for performing an operation of rotating the operation wire alone with respect to another member in the direction around the axis. .

  A driven gear may be attached to the proximal end portion of the operation wire, and a drive gear for rotating the driven gear may be provided in the rotation operation means. An intermediate gear may be provided between the driven gear and the drive gear.

  Further, the rotation operation means may be provided with an operation lever for rotating the drive gear, or the rotation operation means may be a single gear meshing with the driven gear. Further, the rotation angle of the rotation operation means may be restricted to less than one rotation.

  Further, as the operation wire, two conductive wires for positive electrode and negative electrode are arranged side by side, and one of the conductive wires is formed of a torque wire and is rotationally driven by the rotation operation means. It may be.

  According to the present invention, the slide operation member provided in the operation unit is provided with the rotation operation means for performing the operation of rotating the operation wire independently with respect to the other members in the direction around the axis line. Excellent operability that allows the distal treatment member provided at the distal end of the flexible sheath to be rotated in the direction around the axis line with an easy operation without requiring an operation to rotate the entire operation unit on the side. Obtainable.

  An operation wire is inserted and disposed in the flexible sheath so as to be movable forward and backward in the axial direction and rotatable in the direction around the axis, and a distal treatment member connected to the distal end of the operation wire is disposed at the distal end portion of the flexible sheath. In addition, a slide operation member that moves the operation wire forward and backward in the axial direction is provided on the operation portion connected to the proximal end of the flexible sheath, and the operation wire is connected to the flexible sheath on the proximal end side of the flexible sheath. In the endoscopic treatment instrument configured such that the distal treatment member rotates in the direction around the axis at the distal end of the flexible sheath by rotating it relative to the direction around the axis. Rotation operation means for performing an operation of rotating the wire independently with respect to another member in the direction around the axis line is provided.

Embodiments of the present invention will be described below with reference to the drawings.
FIG. 2 shows the overall configuration of a first embodiment of the endoscope treatment tool to which the present invention is applied. The endoscope treatment tool of this embodiment is a bipolar high-frequency treatment tool for an endoscope.

  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 distal treatment member 3 is supported on a distal support frame 2 provided at the distal end of the flexible sheath 1. The distal treatment member 3 of this embodiment is a pair of high-frequency electrodes having conductivity. In addition, an operation wire 4 is inserted and arranged 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 over the entire length.

  FIG. 3 shows a distal end portion of such an endoscope treatment tool, and a distal end support frame 2 made of an electrical insulating material is attached to the distal end of the flexible sheath 1 so as to be rotatable in the direction around the axis. . A circumferential protrusion 2a is formed to protrude from the outer peripheral portion of the cylindrical portion near the rear end of the distal end support frame 2 inserted into the distal end of the flexible sheath 1, and the circumferential protrusion 2a is formed into the flexible sheath. It bites into the inner peripheral wall of 1 to prevent it from coming off.

  The pair of high-frequency electrodes, which are the distal treatment members 3, are supported by the distal support frame 2 while being electrically insulated from each other so as to be openable and closable forwardly around the support shaft 5. The operation wire 4 of this embodiment is two conductive wires 4A and 4B, which are individually connected to the rear end portions of the pair of high-frequency electrodes that are the distal treatment members 3.

  At least one of the two conductive wires 4A and 4B that are the operation wires 4 is a torque wire (4A) having good rotational followability, and the two conductive wires 4A and 4B are provided in the flexible sheath 1. They are bound together by a binding member 6 at an appropriate position. Reference numeral 7 denotes an insulating tube placed on the torque wire 4A.

  Therefore, when the operation wire 4 is moved back and forth in the axial direction from the proximal end side, the pair of high-frequency electrodes as the distal treatment member 3 opens and closes in a bowl shape as indicated by the two-dot chain line, and the operation wire 4 is By rotating relative to the flexible sheath 1 in the axial direction, the distal treatment member 3 connected to the distal end of the operation wire 4 rotates in the axial direction at the distal end of the flexible sheath 1.

  However, as indicated by the arrow B, if only the torque wire 4A of the two conductive wires 4A and 4B is rotated from the proximal end side in the direction around the axis, the entire operation wire 4 is axially moved at the distal end. As shown by an arrow C, the distal treatment member 3 rotates in the axial direction, and the direction (opening / closing direction) of the distal treatment member 3 changes at the distal end of the flexible sheath 1.

  Returning to FIG. 2, reference numeral 10 denotes an operation unit, and a slide operation member 12 for advancing and retracting the operation wire 4 in the axial direction to the operation unit body 11 to which the proximal end of the flexible sheath 1 is fixedly connected. Is slidably mounted. The slide operation member 12 can be slid along a slit 13 formed in the longitudinal direction of the operation unit main body 11, thereby opening and closing the distal treatment member 3.

  Reference numeral 30 denotes two high-frequency power cords that are electrically connected to the two conductive wires 4A and 4B and extend from the slide operation member 12, and a connection plug 31 that is connected to a high-frequency power supply device (not shown). The high frequency power cord 30 is attached to the tip.

  The slide operation member 12 is provided with a rotation operation knob 14 (rotation operation means) for performing an operation of rotating the operation wire 4 (here, the torque wire 4A) alone around the axis with respect to other members. .

  As a result, if the rotary operation knob 14 is rotated as indicated by the arrow A, the torque wire 4A rotates in the direction around the axis with respect to the flexible sheath 1, and the distal treatment member is formed at the distal end of the flexible sheath 1. 3 rotates in the direction around the axis with respect to the flexible sheath 1, and the opening / closing direction of the distal treatment member 3 at the distal end of the flexible sheath 1 changes.

  FIG. 1 is a side sectional view of such an operation unit 10, and FIG. 4 is a IV-IV sectional view. Reference numeral 16 denotes a wire drive seat made of an electrically insulating member that is integrally coupled to the slide operation member 12 and is loosely disposed in the slit 13 of the operation unit main body 11, and is formed there in a direction parallel to the axis. Two conductive wires 4A and 4B constituting the operation wire 4 are individually passed through the two through holes.

  An elongated driven gear 17 made of conductive metal is fixed to the proximal end portion of the torque wire 4A of the two conductive wires 4A and 4B, and is disposed in the through hole of the wire drive seat 16 so as to be rotatable around the axis. When the driven gear 17 thus rotated rotates, the base end of the torque wire 4A rotates in the direction around the axis.

  Reference numerals 18 and 19 are thrust stoppers attached to both ends of the driven gear 17 so that the driven gear 17 does not move in the axial direction with respect to the wire drive seat 16, and are attached to the driven gear 17 so as to be rotatable in the direction around the axis. One high-frequency power cord 30 and the torque wire 4A are electrically connected to each other via the thrust stopper 19 on the rear side.

  Another conductive wire 4B constituting the operation wire 4 loosely passes through a through-hole formed in the wire drive seat 16 and is connected to another high-frequency power cord 30. Accordingly, the pair of high-frequency electrodes constituting the distal treatment member 3 are connected to the positive electrode and the negative electrode of the high-frequency power source via the two conductive wires 4A and 4B.

  In this embodiment, the rotary operation knob 14 formed of an electrical insulating material is a single drive gear that meshes with the driven gear 17, and is rotatably supported by the slide operation member 12 by the support shaft 15 in a state of meshing with the driven gear 17. ing.

  As a result, when the rotary operation knob 14 is rotated as indicated by the arrow A, the driven gear 17 is thereby driven to rotate, and the proximal end portion of the torque wire 4A is rotated as indicated by the arrow B. Is transmitted to the distal end of the torque wire 4A, the distal treatment member 3 rotates in the direction around the axis at the distal end of the flexible sheath 1, as indicated by an arrow C in FIGS.

  Therefore, it is provided at the distal end of the flexible sheath 1 by a simple operation of rotating the rotary operation knob 14 alone in the operation unit 10 without requiring an operation for rotating the entire operation unit 10. The distal treatment member 3 can be rotated in the direction around the axis with respect to the flexible sheath 1, and extremely excellent operability can be obtained.

  FIG. 5 shows an operation unit 10 of an endoscope monopolar type high-frequency treatment tool which is a second embodiment of the endoscope treatment tool to which the present invention is applied. In this example, there is only one operation wire 4 made of a conductive wire, and the distal end portion 32a of the conductive member of the high frequency power cord connection terminal 32 disposed on the slide operation member 12 instead of the high frequency power cord 30 is rotated. The proximal end side surface of the knob 14 is always in contact with and electrically connected.

  The distal treatment member 3 is provided at the distal end of the flexible sheath 1 so as to be rotatable in the direction around the axis, similar to the first embodiment, and can be advanced and retracted in the flexible sheath 1 in the axial direction. The distal treatment member 3 is driven by an operation wire 4 that is rotatably inserted in the direction around the axis. The operation wire 4 is preferably a torque wire from the viewpoint of responsiveness of rotation transmission, but may not necessarily be a torque wire.

  6 is a side cross-sectional view of the operation unit 10 of the second embodiment, and FIG. 7 is a cross-sectional view of VII-VII. A driven gear 17 fixed to the proximal end of the operation wire 4 is rotated by a rotary operation knob 14. Then, the operation wire 4 is rotated around the axis and the movement is transmitted to the distal end side as in the first embodiment. As described above, the present invention can be applied to a monopolar high-frequency treatment instrument, and can be applied to a mechanical endoscope treatment instrument that does not use a high-frequency current.

  FIG. 8 shows a third embodiment of the present invention, in which an operation lever for rotating the drive gear meshing with the driven gear 17 is integrally provided as the rotary operation knob 14. With this configuration, manual operation can be performed more easily. The operation lever may be provided separately from the drive gear.

  If such an operation lever system is used, the amount of rotation operation is restricted to less than one rotation (for example, about 90 to 150 °), but depending on the size of the gear ratio with the driven gear 17, the amount of rotation operation knob 14 is that much. Since the driven gear 17 rotates a plurality of times by the rotation, it is sufficient as an operation necessary to change the direction of the distal treatment member 3, and is rather easy to operate. Such restrictions can also be applied to the first and second embodiments.

  FIG. 9 shows a fourth embodiment of the present invention, in which an intermediate gear 21 is provided between the drive gear of the rotary operation knob 14 and the driven gear 17. By configuring in this way, the rotation direction of the rotary operation knob 14 and the rotation direction of the operation wire 4 coincide with each other.

It is side surface sectional drawing of the operation part of the treatment tool for endoscopes of 1st Example of this invention. 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 part of the treatment tool for endoscopes of 1st Example of this invention. It is front sectional drawing (IV-IV sectional drawing in FIG. 1) of the operation part of the treatment tool for endoscopes of 1st Example of this invention. It is a top view of the operation part of the treatment tool for endoscopes of the 2nd Example of the present invention. It is side surface sectional drawing of the operation part of the treatment tool for endoscopes of the 2nd Example of this invention. It is front sectional drawing (VII-VII sectional drawing in FIG. 6) of the operation part of the treatment tool for endoscopes of the 2nd Example of this invention. It is front sectional drawing of the operation part of the treatment tool for endoscopes of the 3rd Example of this invention. It is front sectional drawing of the operation part of the treatment tool for endoscopes of the 4th Example of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Flexible sheath 3 Tip treatment member 4 Operation wire 4A Torque wire 10 Operation part 11 Operation part main body 12 Slide operation member 14 Rotation operation knob (rotation operation means)
17 Driven gear 21 Intermediate gear

Claims (7)

An operation wire is inserted and disposed in the flexible sheath so as to be movable forward and backward in the axial direction and rotatable in the direction around the axis, and a distal treatment member connected to the distal end of the operational wire is attached to the distal end portion of the flexible sheath. A slide operation member that moves the operation wire back and forth in the axial direction is provided on the operation portion that is arranged and connected to the proximal end of the flexible sheath, and the operation is performed on the proximal end side of the flexible sheath. An endoscope treatment configured such that the distal treatment member rotates in the direction around the axis at the distal end of the flexible sheath by rotating the wire relative to the flexible sheath in the direction around the axis. In the ingredients,
An endoscopic treatment tool, wherein the slide operation member is provided with a rotation operation means for performing an operation of rotating the operation wire independently with respect to another member in the direction around the axis.   The endoscope treatment instrument according to claim 1, wherein a driven gear is attached to a proximal end portion of the operation wire, and a drive gear for rotating the driven gear is provided in the rotation operation means.   The endoscope treatment tool according to claim 2, wherein an intermediate gear is provided between the driven gear and the drive gear.   The endoscopic treatment tool according to claim 2 or 3, wherein the rotation operation means is provided with an operation lever for rotating the drive gear.   The endoscope treatment tool according to claim 2, wherein the rotation operation means is a single gear meshing with the driven gear.   The endoscope treatment tool according to any one of claims 1 to 5, wherein a rotation angle of the rotation operation means is restricted to less than one rotation.   2. The control wire includes two conductive wires for a positive electrode and a negative electrode arranged side by side, and one of the conductive wires is formed of a torque wire and is rotationally driven by the rotational operation means. The treatment tool for endoscopes according to any one of Items 6 to 6.

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