JP2010263959A - External holding tool - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a holding tool holding tissue inside a subject without receiving the interference of a bending operation of an endoscope distal end, securing the multiple visual fields of an excision site and being inserted into the subject together with an endoscope, to provide the holding tool performing sure and stable holding even when the tissue inside the subject is in a complicated shape having recesses and projections without damaging the tissue inside the subject, and further to provide the holding tool excising even a relatively large lesional tissue altogether. <P>SOLUTION: The external holding tool includes a suction head for sucking and holding the tissue inside the subject, an insertion pipe having the suction head on the distal end to be inserted into the body, and a suction pump for sucking the inside of the insertion pipe, wherein the insertion pipe is inserted into the subject together with the endoscope by being held by holding forceps mounted on the endoscope, and it is paired with the endoscope and utilized. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention mainly relates to an external grasping tool that is inserted into a subject together with an endoscope and adsorbs and grasps the tissue in the subject when performing endoscopic submucosal dissection (ESD) or the like.

In recent years, ESD treatment is performed as one of endoscopic operations due to advances in endoscopic treatment tools such as IT knives, flex knives, and hook knives. ESD is a method in which an endoscope is inserted into a subject, a submucosal layer is peeled off using a knife or the like disposed at the distal end of the endoscope, and a lesion site is excised. At this time, the lesioned tissue is pulled up using forceps, and the excision site is confirmed while observing the boundary between the lesioned tissue and the normal tissue with an endoscope. Compared to the conventional endoscopic mucosal resection (EMR), the treatment method using ESD enables safe resection of large lesions with a single resection, and lump excision of the diseased tissue. The rate is high. Therefore, the treatment can be performed in a shorter time and the recurrence due to the remains of the diseased tissue can be avoided, so that it is an effective treatment method for both the operator and the patient. Therefore, improvement and development of appliances used for ESD are underway.

  For example, in the endoscope treatment tool described in Patent Document 1, a grasping forceps for pulling up a diseased tissue is attached to a cylindrical portion, and this is attached to the distal end of the endoscope, and the mucosa is turned with the grasping forceps. Raised and viewed in front of the submucosal layer with an endoscope. As for the grasping forceps, a configuration in which a lesion tissue is sandwiched by a pair of forceps corresponding to a scissors blade in a scissors shape, a configuration in which a tube connected to a suction source is adsorbed to a lesion tissue and gripped is disclosed. ing. Since the endoscope treatment tool can be inserted into the subject integrally with the endoscope and the grasping forceps, there is no need to provide an opening for inserting the grasping forceps in addition to the opening for inserting the endoscope. The burden on the subject is extremely small.

JP2008-173369 JP2002-238913

  However, since the grasping forceps of the endoscope treatment tool described in Patent Document 1 is attached to the endoscope via the tube portion, the operation of the grasping forceps is interfered with the operation of the endoscope. For example, as shown in FIG. 6, the grasping forceps (0601) and the cylindrical portion (0602) are integrated with the endoscope (0604) to move only in the same direction, and when the endoscope is moved, it is grasped at the same time. The forceps also move. Therefore, it is difficult to observe the excision site from various angles, and an advanced technique is required for the surgeon. In addition, when the grasping forceps has a saddle shape as shown in FIG. 6, it is easy to slip even when trying to pinch a lesion tissue that is soft and wet with blood, body fluid, etc. Have difficulty. In addition, if the object is firmly held for gripping, or if the same part is held many times, the diseased tissue may be damaged.

Further, the forceps described in Patent Document 2 are used independently of the endoscope, and the forceps are not interfered with the operation of the endoscope. Therefore, the in-vivo site desired by the surgeon can be observed with an endoscope, but in the case of endoscopic surgery in the abdominal cavity, in addition to the opening for inserting the endoscope into the subject, forceps are further inserted. For this reason, an opening is provided in the abdomen and a forceps is inserted through the opening, so that the burden on the subject is extremely large.
Therefore, in view of the above problems, the present invention grasps the tissue in the subject without receiving interference of the bending operation of the distal end of the endoscope, secures a multi-angle field of view of the excision site, and combines the subject with the endoscope. It is an object of the present invention to provide a gripping tool that can be inserted into an object. It is another object of the present invention to provide a grasping tool capable of reliably grasping without damaging a subject tissue.

  (1) The present invention includes an adsorption head for adsorbing and grasping tissue in a subject, an insertion pipe for inserting the adsorption head at the tip and inserting the tissue into the body, and a suction pump for sucking the inside of the insertion pipe. An external grasping tool characterized in that an insertion pipe or a suction head is grasped by grasping forceps attached to an endoscope and inserted into a subject together with the endoscope and used as a pair with the endoscope. I will provide a.

  (2) The present invention provides the outer gripping tool according to (1), wherein the suction head is formed of a bellows-like pipe and the suction port can be flexibly changed in direction within the subject. provide.

  (3) The present invention further includes a vacuum regulator for adjusting the suction of the suction pump, and a storage container for storing the suctioned material sucked by the suction pump. ) Is provided.

  According to the external grasping tool of the present invention, it is possible to adsorb and grasp the in-vivo tissue without being interfered with the operation of the endoscope, so that the in-vivo site desired by the operator can be observed with the endoscope. In addition, both the endoscope and the external gripping tool can be inserted into the subject through one opening while being gripped by the endoscope. In addition, it is possible to reliably and stably hold an in-vivo tissue that is not damaged and has unevenness.

Overview of the present invention Conceptual diagram showing how to use the present invention Example of suction head shape Conceptual diagram showing the flexibility of the suction port of the bellows-like pipe of the suction head Conceptual diagram showing the state in which the diseased tissue peeled off by the suction head is taken inside An example of a conventional endoscope treatment tool

Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. In addition, this invention should not be limited to these embodiments at all, and can be implemented in various modes without departing from the gist thereof.
<< Embodiment 1 >>
<Embodiment 1: Overview>

  FIG. 1 shows a conceptual diagram of the present invention. The outer gripping tool of the present invention includes a suction head (0101), an insertion pipe (0102), and a suction pump (0103). When the suction pump is started, the suction head sucks and holds the tissue in the subject.

FIG. 2 is a conceptual diagram showing how to use the invention. As shown in FIGS. 2A and 2B, the suction head (0201) and the insertion pipe (0202) of the outer gripping tool have gripping forceps (insertion pipe (0202) inserted into the endoscope (0204). 0205), and inserted into the subject, and is guided to the subject tissue to be grasped by the external grasping tool by the operation of the endoscope and grasping forceps by the operator. In addition, the dotted line in a figure shows a visual field range. Then, as shown in (c), a suction pump (not shown) is started, the suction head of the outer gripping tool sucks and grips the body tissue, and the gripping forceps release the grip of the insertion pipe. The grasping forceps are taken out from the endoscope, and a knife (0206) for exfoliating and excising the diseased tissue is inserted into the endoscope instead. Subsequently, as shown in (d), only the endoscope is moved, the field of the excision site desired by the operator is secured, and the tissue in the subject that is adsorbed and grasped while observing the excision site is removed and excised. I do. Thus, the operator can ensure the visual field of the desired excision site because the direction in which the outer gripping tool grips and pulls up the in-vivo tissue does not interfere with the visual field direction secured by the endoscope. The excised diseased tissue is sucked with an insertion pipe and taken out of the subject, or taken out of the subject together with the insertion pipe while the suction head is adsorbed.
<Embodiment 1: Configuration>

  The external gripping tool of the present invention is a gripping tool that is inserted into a subject together with an endoscope in a state where the insertion pipe (0102) is gripped by the gripping forceps of the endoscope and is used as a pair with the endoscope. . Therefore, only one insertion port is required for inserting the endoscope and the external gripping tool into the subject. In addition, since the endoscope and the insertion pipe are fixed to each other at the insertion tip, the endoscope and the insertion pipe of the external grasping tool are always in close proximity without any variation in the subject. It can also be inserted into a relatively narrow area within the subject. In addition, only by operating the endoscope and the grasping forceps, it is possible to simultaneously guide the external grasping tool to the in-vivo tissue together with the endoscope.

  The “adsorption head” (0101) has a function of adsorbing and grasping the in-vivo tissue. Suction is generated at the suction port of the suction head by a suction pump described later. Here, the “tissue in the subject” refers to a region that the outer gripping tool should suck and grip in order to peel and excise a lesion site in the subject. In addition to the case of a diseased tissue, normal tissue around the diseased tissue is also included. Since the suction head directly grips the in-vivo tissue, it is not particularly limited as long as it is a material that does not adversely affect the living body. However, a material that can prevent damage to the in-vivo tissue is preferable. In addition, since the living body is always wet with blood, body fluid, or the like, a material that is difficult to slip when gripping is preferable. In view of these points, relatively soft and deformable materials such as rubber and resin are more preferable. For example, silicon rubber, fluorine rubber, urethane rubber, nitrile rubber, and the like. Further, a structure in which the suction head is detachable, only the suction head can be replaced, and a sterilization process or the like can be easily performed is preferable.

  The shape of the suction head is illustrated in FIG. Since the cylindrical shape of (a) and the trumpet shape of (b) are very simple structures, production at a low cost is possible. In addition, (b) has a larger suction port area than (a), and thus enables more stable suction gripping. Further, (c) to (e) have a bellows shape that can be expanded and contracted. When the suction head is made of a bellows-shaped pipe, as shown in FIG. 4, the suction port (0403) of the suction head (0401) can be flexibly oriented in the subject without changing the orientation of the insertion pipe (0402). Because it can be changed, operability is extremely high. In such a case, the more the bellows, the wider the range in which the direction can be changed.

  Further, when the suction head has a multi-stage bellows shape, even when the excision site is large as shown in FIG. 5, the peeled lesion tissue can be taken into the suction head, so that relatively large lesion tissues can be collectively removed. , Avoiding the remains of diseased tissue.

  The “insertion pipe” (0102) is for inserting the suction head (0101) at the tip and inserting it into the body. The material is not particularly limited as long as it is a material that does not adversely affect the organ or tissue when it comes into contact with an organ or tissue in order to move in the living body. When inserted into the subject, since it is gripped by the grasping forceps of the endoscope, a material that can withstand repeated gripping by the grasping forceps is more preferable. In addition, the structure which makes an attachment or detachment of an adsorption | suction head easy by providing an adapter at the front-end | tip of an insertion pipe and attaching an adsorption | suction head to the said adapter may be sufficient. In this case, since the adsorption head, adapter, and insertion pipe can be assembled and disassembled, sterilization can be easily performed. Further, any one or more of the suction head, the adapter, and the insertion pipe may be disposable. In such a case, the safety to the living body can be further secured.

  The “suction pump” (0103) is for sucking the inside of the insertion pipe. Since it is possible to operate adsorption and non-gripping of the tissue within the subject simply by controlling the on / off of the suction pump, for example, when a button for controlling the on / off of the suction pump is placed at the operator's foot, the operator must Can be operated. In addition, as shown in FIG. 1, in order to adjust the suction | attraction of a suction pump (0103), you may have a vacuum regulator (0104). For example, if the in-vivo tissue is flat, the suction is relatively weakened and adjusted so as to suppress damage to the in-vivo tissue as much as possible while securely grasping it. In addition, if the tissue in the subject is an uneven surface, the suction is relatively strong and adjusted so that it can be securely adsorbed and held.

In addition, the outer gripping tool of the present invention may further include a storage container (0105) that stores the sucked material sucked by the insertion pipe (0102). In addition to housing the exfoliated and excised diseased tissue, for example, blood or body fluid around the tissue in the subject is aspirated to prevent the suction head from slipping, and the subject tissue is adsorbed and grasped reliably and stably.
<Embodiment 1: Effect>

  According to the external grasping tool of the present invention, it is possible to adsorb and grasp a diseased tissue without being interfered with the operation of the endoscope. Therefore, the in-vivo site desired by the operator can be observed with the endoscope. In addition, both the endoscope and the external gripping tool can be inserted into the subject through one opening while being gripped by the endoscope. In addition, it is possible to reliably and stably hold an in-vivo tissue that is not damaged and has unevenness.

0201 Suction head 0202 Insertion pipe 0203 Lesion tissue 0204 Endoscope 0205 Grasping forceps 0206 Knife

Claims (3)

An adsorption head for adsorbing and grasping the tissue in the subject;
An insertion pipe for inserting the suction head at the tip and inserting it into the body,
A suction pump for sucking the inside of the insertion pipe,
An external gripping tool that is inserted into a subject together with an endoscope by using an insertion pipe or a suction head that is gripped by gripping forceps attached to the endoscope, and used as a pair with the endoscope.   The outer gripping tool according to claim 1, wherein the suction head is formed of a bellows-like pipe so that the suction port can be flexibly changed in direction within the subject. A vacuum regulator for adjusting the suction of the suction pump;
The outer gripping tool according to claim 1, further comprising: a storage container that stores the suctioned material sucked by the suction pump.

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