JP2014223230A - High-frequency cautery incision scissors for endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide high-frequency cautery incision scissors having excellent sharpness by preventing opening/closing inhibition of scissor pieces by seizure of a biological tissue due to cautery incision.SOLUTION: A pair of scissor pieces 10A and 10B retained by arm parts 7A and 7B of a treatment part 100 and opened/closed by links 6A and 6B, the treatment part 100 being connected to a distal end of a flexible sheath 200 that is inserted/retracted with respect to a treatment tool guide tube of an endoscope, are journaled to a shaft 11 via an interval ring 90 with a prescribed dimension width. Consequently, the pair of scissor pieces 10A and 10B are opened/closed with the prescribed dimension interval, and the high-frequency cautery incision scissors include embossed blade surfaces 30.

Description

  The present invention relates to an endoscopic high-frequency cautery incision scissor that is inserted into a treatment instrument guide pipe of an endoscope so as to be able to advance and retreat, and cauterizes and incises a living tissue in a body cavity while energizing a high-frequency current.

  In general, a high-frequency cautery incision scissor for an endoscope is a scissors incised while cauterizing a living tissue by applying a high-frequency current to a pair of scissors with high-frequency electrodes arranged on the inner surface. The following patent documents can be cited as documents that describe techniques related to the incision fold.

  In this Patent Document 1, a pair of opening and closing hook pieces projecting inward in a state in which the hook pieces are opened at the tips of a pair of blade portions provided from the inner surface to the outer surface, and rounded shapes. The desired biological tissue when incising and excising the desired biological tissue site by preventing the target biological tissue site from being pushed forward by the blade when the projection is incised and excised. An endoscopic scissors forceps technique that prevents influences other than on the site and increases the degree of freedom of incision and excision work is described.

JP-A-2005-204998

  Although the incision scissors for endoscopes described in the above-mentioned patent documents can improve the operability of the incision and excision work, incision is performed while cauterizing the living tissue by energizing the scissors with high-frequency current. In the high-frequency cautery incision scissors for endoscope, there is a problem that when the living tissue is incised, the living tissue is seized, and the living tissue adheres to a pair of shearing pieces that are sheared and the opening and closing of the scissors is hindered. It was. In addition, it is conceivable to prevent seizure of the biological tissue by applying a fluorine-based coating on the shear surface of the cocoon. In this case, the baked solidified or carbonized biological tissue is interposed between the pair of cocoon pieces. There was also a problem that clogging and the opening and closing of the bag were hindered. Furthermore, in the prior art, since the scissors are in close contact with each other, there is a problem that bleeding is likely to occur because the body tissue is sheared when the living tissue is sandwiched before the high-frequency current is applied.

  In view of such problems, the present invention is intended to solve the above-described problems caused by the prior art, and has a sharp cutting-edge high-frequency without obstructing the opening and closing of wrinkles due to seizure of living tissue. An object is to provide a cautery incision fistula.

  In order to achieve the above object, according to the present invention, a distal end support frame having a pair of arms is disposed at the distal end of a flexible sheath that is inserted into and removed from a treatment instrument guide tube of an endoscope. Endoscopic high-frequency cautery incision scissors having a pair of scissors that have blade surfaces facing each other so as to open and close in a circular arc shape on the front end side with the rear end side as a rotation fulcrum by operation from the base end side And the pair of arm portions pivotally support the pair of flange pieces inserted through an annular interval ring having a predetermined thickness, thereby opening and closing the pair of flange pieces at a predetermined interval. The first feature is that the blade surface is roughened.

  Further, according to the present invention, a distal end support frame having a pair of arms is disposed at the distal end of a flexible sheath that is inserted into and removed from a treatment instrument guide tube of an endoscope, and the proximal end side of the flexible sheath is In the high-frequency cautery incision scissors for endoscope, in which a pair of scissors having opposing blade surfaces that open and close in a circular arc shape on the front end side with the rear end side as a rotation fulcrum by operation, One or both of the flanges are provided with spacer seats that project toward the other opposing flanges as compared to the blade surface, and the pair of flanges are pivotally supported using the pair of arm portions. Thus, the second feature is that the pair of scissors pieces are held so as to open and close at intervals of a predetermined dimension, and the blade surface is subjected to uneven processing.

  Furthermore, the present invention is the endoscopic high-frequency cautery incision scissor according to the first or second feature, wherein the entire pair of scissors is formed of a conductive metal, and the outside of the part other than the blade surface of the scissors. A third feature is that the surface is coated with an electrically insulating coating, and in the high-frequency cautery scissors for endoscope according to the first or third feature, the annular spacing ring is electrically insulated on the outer surface. In the high-frequency cautery incision scissors for endoscope according to the second or third feature, the spacer seat is electrically insulative on the outer surface in contact with the other scissors. A fifth feature is that the coating is coated.

  Further, according to the present invention, in the endoscopic high-frequency cautery incision scissors having any one of the above characteristics, the pair of scissors are electrically insulated from each other, and one scissors are positive and the other scissors are A sixth feature is that electrical application is performed as a negative electrode. In the endoscopic high-frequency cautery incision scissors having the same feature, the irregularities due to the irregular processing of the blade surface are irregular irregularities. The eighth feature is that in the high-frequency cautery incision scissors for endoscopes of any one of the features described above, the concave and convex portions formed by the concave and convex processing on the blade surface have hemispherical concave portions continuous in the axial direction. To do.

  Furthermore, the present invention provides the endoscopic high-frequency cautery incision scissor according to any one of the above features, wherein the pair of scissors has a shape in which the blade surface extends from the rear end substantially linearly toward the front end, and the front end is the inner surface. A ninth feature is that the distal end has a curved portion curved in the direction.

  Further, the present invention is the endoscopic high-frequency cautery incision scissor according to any one of the above features, wherein the entire pair of scissors is formed of a conductive metal, and the outer surface of a portion other than the blade surface of the scissors And the blade surface is formed of a flat portion and an inclined portion that is notched so as to incline from the flat portion to the other flange side. In the high-frequency cautery incision scissors for endoscope, the entire pair of scissors is formed of a conductive metal, and an outer surface of the part other than the blade surface of the scissors is covered with an electrically insulating coating, and the blade surface The eleventh feature is that the blade surfaces face each other, and in the high-frequency cautery incision scissors for an endoscope having the same features, the entire pair of scissors is made of a conductive metal, and the scissors The outer surface of the portion other than the blade surface is coated with an electrically insulating coating According to a twelfth feature of the present invention, the blade surfaces are formed into inclined surfaces where the blade surfaces face each other. In the high-frequency cautery incision scissors for endoscope having the same features, the entire pair of scissors pieces are formed of a conductive metal. A thirteenth feature is that the outer surface of the flange other than the blade surface is coated with an electrically insulating coating, and the blade surface is formed in an arc shape protruding in the opening and closing direction.

  The high-frequency cautery incision scissors for endoscope according to the present invention is configured such that a pair of scissors are opened and closed with a predetermined distance by an annular spacing ring or a spacer seat, so that the scissors do not come into contact with each other at the time of opening and closing. It is possible to reduce the seizure of living tissue due to cautery incision in a state where a high-frequency current is applied, to prevent the opening and closing of the scissors from being obstructed, and to perform uneven processing on the blade surface. Since each part first discharges to the mucosal surface and the mucosa begins to be incised, a smooth incision can be performed.

The whole external appearance perspective view of the high frequency cautery incision scissors for endoscopes of this invention. The figure for demonstrating the front-end | tip part of the high frequency cautery incision scissors for endoscopes by 1st Embodiment. The figure which shows the cross section of the front-end | tip part of the high frequency cautery incision scissors for endoscopes of 1st Embodiment. The external appearance perspective view of the front-end | tip part of the high frequency cautery incision scissors for endoscopes by 1st Embodiment. The figure for demonstrating the electrode of the front-end | tip part of the high frequency cautery incision scissors for endoscopes by 1st Embodiment. The figure for demonstrating the uneven | corrugated process of the high frequency cautery incision scissors for endoscopes by 1st Embodiment. The figure for demonstrating the front-end | tip part of the high frequency cautery incision scissors for endoscopes by 2nd Embodiment of this invention. The figure for demonstrating the high frequency cautery incision scissors for endoscopes by 3rd Embodiment of this invention. CC line expanded sectional view in FIG. 2 of the high frequency cautery incision scissors for endoscopes by 4th Embodiment of this invention. The figure explaining the effect of the high frequency cautery incision scissors for endoscopes by 4th Embodiment of this invention. The CC sectional expanded sectional view in FIG. 2 which shows the modification of the high frequency cautery incision scissors for endoscopes by 4th Embodiment of this invention. The figure for demonstrating the front-end | tip part of the high frequency cautery incision scissors for endoscopes by 5th Embodiment of this invention.

Hereinafter, embodiments of the high-frequency cautery incision scissors for endoscope according to the present invention will be described in detail with reference to the drawings.
[First Embodiment]
As shown in FIG. 1, the high-frequency cautery incision scissors for endoscope according to the first embodiment of the present invention is disposed on the distal end side, and is pivotally supported by a pivot shaft 11 to rotate between an open state and a closed state. An operation unit 500 including a treatment unit 100 including a pair of displaceable scissors pieces 10A and 10B, a handle 400 disposed on the proximal end side and gripped by an operator, and a slider 300 movable relative to the handle 400; A cylindrical flexible sheath 200 disposed between the treatment unit 100 and the handle 400, and an operation wire 230 that is inserted into the flexible sheath 200 and disposed between the treatment unit 100 and the slider 300. By moving the handle 400 and the slider 300 relative to each other, the operation wire 230 is moved forward and backward to displace the hooks 10A and 10B between the open state and the closed state. It is configured. That is, at the relative position between the slider 300 and the handle 400 shown in FIG. 1A, the slider 300 is moved in the direction of arrow A with the handle 400 as a base point, as shown in FIG. The heel pieces 10A and 10B of the treatment section 100 on the side are configured to be in an open state.

  As shown in FIG. 2A, the flexible sheath 200 has a flexible coil pipe 220 in which a metal such as a stainless steel wire is tightly wound, and an insulating property that covers the outer periphery of the coil pipe 220 with flexibility. The sheath outer sheath 210 is fixed to the outer periphery of the distal end cap 8 fixedly attached to the distal end of the coil pipe 220. Instead of using the coil pipe 220 and the sheath 110, the flexible sheath 200 may be composed of only a flexible tube such as PTFE (Polytetrafluoroethylene), PEEK (Polyether ether ketone), polyethylene, and polyimide resin.

As shown in the perspective views of FIGS. 2B and 4, the treatment section 100 has a distal end support having arms 7 </ b> A and 7 </ b> B extending to the distal end side via a distal end cap 8 at the distal end of the flexible sheath 200. The frame 7 is connected. Then, they are pivotally supported by the rotating shaft 11 extending between the arm portions 7A and 7B to be rotationally displaced between the open state and the closed state, and the blade surface 30 extends from the rear end to the front end substantially linearly. A pair of flanges 10A and 10B made of a conductive metal having curved portions 10a and 10b whose front ends are curved in the inner surface direction (closing direction), and the rear end side of the pivots 11 of the flanges 10A and 10B. A pair of links 6A and 6B, which are rotatably attached to the arranged shaft 12A or 12B, and the rear ends of the links 6A and 6B are pivotally supported (held) coaxially. At the same time, by having the shaft 13 attached to the wire connecting member 5 attached to the operation wire 230, the link 6A and the link 6B are opened when the operation wire 230 is moved in the left direction in the figure. Accordingly, as shown in FIG. 2B, the hooks 10 </ b> A and 10 </ b> B supported by the rotating shaft 11 are configured to open and close, and the operation is performed from the plug 301 provided on the slider 300 of the operation unit 500. By applying a high-frequency current to the treatment unit 100 through the wire 230, the living tissue in contact with the sepals 10A and 10B is incised while cauterizing.
In the present embodiment, an example of opening and closing using the links 6A and 6B is shown, but the present invention is not limited to this, and the opening and closing may be performed by another mechanism.

Further, the treatment unit 100 is inserted between the collar piece 10A and the collar piece 10B on the rotating shaft 11, and an annular spacing ring 90 which provides a distance L between the facing surfaces of the collar piece 10A and the collar piece 10B. And the flanges 10A and 10B are configured to open and close with an interval L.
The annular spacing ring 90 is a metal washer having good slidability in which the cauterized mucous membrane having a thickness of 0.02 mm to 0.3 mm is hard to be seized when the lengths of the blades 10A and 10B are 3 mm to 8 mm. Further, a mutual space is maintained by a washer such as a polymer material such as polyimide, nylon, POM (polyacetal) or PTFE (polytetrafluoroethylene). Further, the annular spacing ring 90 according to the present embodiment may be conductive when the high-frequency current supplied to the treatment unit 100 is monopolar (single pole), and is insulated when bipolar (bipolar) described later is used. It is preferable to use a material.

  The spacing between the scissors 10A and 10B of the treatment section 100 is as shown in FIG. 3 (a) to FIG. 3 (c) showing cross sections AA to CC in FIG. 2 (a). As shown in FIGS. 3 (d) to 3 (e), a gap is formed from the most distal end portion to the rear end portion, and the DD cross section to the EE cross section of FIG. 2 (a) are shown. In addition, a gap is formed by the spacing ring 90 also in the shafts 12A and 12B from the vicinity of the rotation shaft 11 of the flanges 10A and 10B sandwiched by the spacing between the arm portions 7B.

The blade surfaces 30 of the flanges 10A and 10B are irregularly and finely textured with a file or a paper file. The width of the blade surface 30 (the width of the blade surface in the thickness direction of the flanges 10A and 10B). ) Is set to 0.05 to 0.4 mm, it is preferable that the shape of the unevenness is 10th to 800th unevenness.
In addition, the uneven | corrugated process of the blade surface 30 is not restricted to the said file etc., As shown in FIG. 6, you may carry out by laser pulse irradiation and may form so that a hemispherical recessed part may continue in an axial direction. In that case, pulse irradiation is performed while moving the laser in the axial direction. The spot diameter is preferably 0.05 to 0.4 mm.

As described above, the treatment section 100 according to the present embodiment allows the collar pieces 10A and 10B to contact each other with the interval L via the pivot shaft 11 that coaxially supports the collar pieces 10A and 10B of the treatment section 100. The gap ring 90 is sandwiched so as to be opened and closed without opening, so that the living tissue that solidifies when the affected part is cauterized and incised is prevented from sticking to the scissors piece that is seized and sheared. Can be prevented, and bleeding when a body tissue before applying a high-frequency current is sandwiched can be reduced, and a safe treatment can be performed.
Then, by performing uneven processing on the blade surfaces 30 of the flanges 10A and 10B, the uneven projections first discharge to the mucosal surface and the mucosa begins to be incised, so that a smooth incision can be performed. It becomes possible.
In addition, the treatment unit according to the present embodiment does not cut the living tissue by shearing force, but cauterizes the living tissue by applying a high-frequency current to the living tissue sandwiched between the blade surfaces 30 of the scissors 10A and 10B. Because it is to be cut, and it is not immediately incised even by lightly pinching the living tissue, reduce bleeding while being a sputum, or carefully apply high-frequency current while visually observing the blade surface that contacts the mucous membrane part Incision can be performed, and the same applies to other embodiments described later. In addition, since the scissors 10A and 10B according to the present embodiment have a slightly curved blade shape, they can be cut into a narrow living tissue, or the damage can be reduced because the thickness is thin. it can.

  The treatment section 100 may be almost entirely covered with an electrically insulating coating made of a so-called inert synthetic resin material having a large chemical and thermal stability such as a fluororesin. As shown in FIG. 5, an electrode portion where the conductive metal is exposed is formed only on the blade surface 30 of the collar pieces 10A and 10B, and a high frequency is supplied from the plug 301 provided on the slider 300 of the operation portion 500 to the treatment portion 100 through the operation wire 230. By applying an electric current, the living tissue in contact with the electrode portion where the conductive metal of the blade surface 30 of the scissors 10A and 10B is exposed may be incised while cauterizing.

[Second Embodiment]
In the above-described endoscopic high-frequency cautery incision scissors according to the first embodiment, the example in which the annular spacing ring 90 is provided as means for providing the spacing between the scissors 10A and 10B has been described. In the cautery incision scissors, the means for providing the spacing is not limited to the spacing ring 90, and as shown in FIG. 7, in the direction of the mating scissors around the hole through which the pivot shaft 11 of the scissors 10A and 10B passes. A protruding spacer seat 91 may be provided.

  As in the first embodiment, the annular spacer seat 91 is preferably 0.02 mm to 0.3 mm thick when the blade tip length direction of the flange pieces 10A and 10B is 3 mm to 8 mm. The distance between 10A and 10B is maintained. Further, in this embodiment, since the spacers 91 are held by the spacers 10A and / or 10B with the spacers 91, the spacers are usually conductive, but the chemicals such as fluorine resin are used. Insulation may also be achieved by coating an electrically insulating film made of a so-called inert synthetic resin material having high thermal stability.

  As shown in FIG. 7C, the high-frequency cautery incision scissors for endoscope according to the second embodiment has an annular shape around a hole 10c through which the rotating shaft 11 of one scissor piece 10A passes, for example. The spacer seat 91 is provided so as to protrude in the direction of the opposite side piece, and as shown in FIG. 7 (a) and FIG. 7 (b) which is a cross-sectional view taken along the line II in FIG. By providing a gap in the heel, the heel pieces 10A and 10B open and close without contact with each other as in the first embodiment, and the seizure of the living tissue that solidifies when the affected part is cauterized and incised is reduced, thereby obstructing the heel opening and closing. In addition to being able to prevent this, it is possible to reduce bleeding when the body tissue before the application of the high-frequency current is sandwiched, and, as in the first embodiment, the tooth surface 30 is subjected to uneven processing. It is possible to make a smooth incision To become.

[Third Embodiment]
Furthermore, as shown in FIG. 8, the high-frequency cautery incision scissors for endoscope according to the present invention has a pair of scissors 10A and 10B electrically insulated from each other, with one scissors serving as a positive electrode and the other scissors serving as the other scissors. A bipolar type in which electrical application is performed with a piece as a negative electrode may be used.
The lids 10A and 10B can be opened and closed by using the links 6A and 6B as in the first embodiment, and further electrically insulated from each other. However, as shown in FIG. An operation wire 25A made of a conductive material that is arranged and covered with an insulating coating 25a is attached to a hole provided on the rear end side of the flange 10A so as to be electrically connected to the flange 10A, and is covered with an insulating coating 25b. An operation wire 25B made of a conductive material is attached to a hole provided on the rear end side of the collar piece 10A so as to be electrically connected to the collar piece 10B, and the operation wires 25A and 25B are connected to the distal end side by an operation from an operation unit (not shown). By moving to the left), the hooks 10A and 10B pivotally supported by the rotating shaft 11 are opened and closed, and the hook 1 is passed through the operation wire 230 from the operation unit. A, it may be configured to apply a high-frequency current to 10B.
Moreover, in the said embodiment, although the example which supports the collar pieces 10A and 10B of the treatment part 100 coaxially with the rotating shaft 11 was shown, it is not restricted to this, Separate rotation between the collar pieces 10A and 10B You may comprise so that the collar pieces 10A and 10B may be supported by a shaft and opened and closed.

  As described above, when the high-frequency cautery incision scissors for the endoscope is of a bipolar type, it is possible to always energize between the scissors pieces 10A and 10B as the electrodes. Smooth incision is possible. That is, in the case of the monopolar type, incision cannot be performed because the current is not supplied after the pieces 10A and 10B pass each other. However, in the case of the bipolar type, the current is supplied even after the pieces 10A and 10B pass each other. Therefore, an incision can be made after a sufficient time for the temperature of the mucosal tissue to rise, the evaporation of water, and coagulation.

[Fourth Embodiment]
Further, the blade surfaces 30 of the scissors 10A and 10B of the high-frequency cautery incision scissors for endoscope according to the present invention are not limited to those formed in a planar shape as shown in the above-described embodiment, but as shown in FIG. The blade surface 30 is formed of a flat surface portion 30a and an inclined portion 30b that is notched so as to be inclined from the flat surface portion 30a to the other hook piece side (inside the hook piece), and the inclined portions 30b face each other diagonally. In other words, the blade surface 30 may be roughened after the blade surface 30 has a chamfered shape that is approximately half the width of the blade surface 30 on the side close to the other flange. .

The endoscopic high-frequency cautery incision scissors according to the fourth embodiment configured as described above has a sharpness when incising a living tissue further than the above-described embodiment by forming the inclined portion 30b on the blade surface 30. Can be improved.
That is, when the electrode portion with the conductive metal exposed is formed only on the blade surface 30 as shown by the hatched lines in FIG. 5 and is a monopolar type, the blade surfaces 30 to which the high-frequency current is applied pass each other. When Joule heat is transmitted to the mucosal tissue and incision is performed and the blade surfaces 30 pass each other, the incision is not performed. However, the blade surface 30 of the present embodiment has a distance d that the blade surfaces 30 pass each other as shown in FIG. Can be made longer than if it is configured as a flat surface, and as a result, the time during which the blade surfaces 30 pass each other becomes longer, so that the time during which Joule heat is transmitted to the mucosal tissue to be incised becomes longer. An incision can be made after a sufficient time for ascending, evaporation of water and coagulation, and a smoother incision can be made.

In addition, as shown in FIG. 11A, the blade surface 30 of the scissors pieces 10A and 10B of the high-frequency cautery incision scissors for endoscope is formed with an irregular shape after the blade surface 30 is formed in an arc shape in which the blade surfaces 30 face each other. As shown in FIG. 11 (b), after forming on the inclined surface where the blade surfaces 30 face each other, the unevenness may be applied, and as shown in FIG. After forming into an arc shape protruding to the surface, uneven processing may be performed.
Even when the blade surfaces 30 are configured in this way, the time for the blade surfaces 30 to pass each other becomes longer, so that a smooth incision is possible.

[Fifth Embodiment]
Further, as shown in FIG. 12, the pair of flanges 10A and 10B may be curved in a plane perpendicular to the opening / closing operation direction, and each flange 10A, 10B is forward of the tip support frame 7. The distance from the central line N of the distal end portion of the flexible sheath 200 (ie, the central line of the distal end support frame 7) gradually increases in the diagonal direction as it goes to the opposite direction, and the central line extends backward from the curved portion. It is formed in a shape that straddles N and reaches the opposite side. As a result, if the outer wall surface of the curved shape is brought into contact with the body tissue surface, the pieces 10A and 10B are not easily brought into contact with the body tissue surface, and the risk of cauterizing the normal body tissue surface is reduced. Further, the bending pieces 10A and 10B do not greatly protrude from the extension line of the outer edge of the distal end support frame 7 (therefore, they can be easily inserted into and removed from the treatment instrument guide tube of the endoscope). It can be taken big. The curved shapes of the two hook pieces 10A and 10B are the same, and therefore the pair of hook pieces 10A and 10B open and close while facing each other. Note that the pair of flange pieces 10A and 10B may be formed in a curved shape on a surface other than a surface perpendicular to the opening / closing operation direction.

  In addition, if the above-mentioned structure is the same, it is the same also with the cautery incision tool by an ultrasonic wave or a microwave, changing to the applied high frequency.

6A, 6B link 7 tip support frame 7A, 7B arm portion 10A, 10B collar piece 10c hole 11 rotating shaft,
12A, 12B Shaft 13 Shaft 30 Blade surface 30a Flat portion 30b Inclined portion 90 Space ring 91 Spacer seat 100 Treatment portion 200 Flexible sheath 210 Sheath skin 220 Coil pipes 25A, 25B, 230 Operation wire 300 Slider 400 Handle 500 Operation portion

Claims (13)

A distal end support frame having a pair of arms is arranged at the distal end of the flexible sheath that is inserted into and removed from the treatment instrument guide tube of the endoscope, and the rear end side is moved by the operation from the proximal end side of the flexible sheath. In the endoscopic high-frequency cautery incision scissors in which a pair of scissors having blade surfaces facing each other so as to open and close in a circular arc shape on the distal end side as a rotation fulcrum is held by the arms,
The pair of arm portions hold the pair of flanges so as to be opened and closed at intervals of a predetermined dimension by pivotally supporting the pair of flanges inserted through an annular interval ring having a predetermined thickness. And
A high-frequency cautery incision scissors for an endoscope, wherein the blade surface is subjected to uneven processing. A distal end support frame having a pair of arms is arranged at the distal end of the flexible sheath that is inserted into and removed from the treatment instrument guide tube of the endoscope, and the rear end side is moved by the operation from the proximal end side of the flexible sheath. In the endoscopic high-frequency cautery incision scissors in which a pair of scissors having blade surfaces facing each other so as to open and close in a circular arc shape on the distal end side as a rotation fulcrum is held by the arms,
Either one or both of the pair of flange pieces is provided with a spacer seat that protrudes toward the other opposite flange piece as compared to the blade surface, and the pair of flange pieces is formed using the pair of arm portions. By supporting the shaft, the pair of hook pieces are held so as to open and close at intervals of a predetermined dimension,
A high-frequency cautery incision scissors for an endoscope, wherein the blade surface is subjected to uneven processing.   The whole of the pair of flanges is formed of a conductive metal, and an electrically insulating coating is coated on an outer surface of a portion other than the blade surface of the flanges. High-frequency cautery incision for endoscope.   The high-frequency cautery incision for endoscope according to claim 1 or 3, wherein the annular spacing ring has an outer surface coated with an electrically insulating coating.   The high-frequency cautery incision scissors for endoscope according to claim 2 or 3, wherein the spacer seat is coated with an electrically insulating coating on an outer surface in contact with another scissors.   The pair of flanges are electrically insulated from each other, and are configured to perform electrical application with one flange as a positive electrode and the other flange as a negative electrode. 5. A high-frequency cautery incision scissors for endoscope according to any one of 5 above.   The high-frequency cautery incision scissors for endoscope according to any one of claims 1 to 6, wherein the unevenness due to the unevenness processing of the blade surface is irregular unevenness.   The high frequency cautery incision scissors for endoscope according to any one of claims 1 to 6, wherein the concave and convex portions formed by the concave and convex processing on the blade surface have hemispherical concave portions continuous in the axial direction.   The shape of the pair of scissors pieces is a tip-curved shape having a curved portion with a blade surface extending from the rear end substantially linearly toward the tip, and the tip being curved toward the inner surface. The high-frequency cautery incision scissors for endoscope according to any one of 1 to 8. The entirety of the pair of scissors is formed of a conductive metal, and the outer surface of the part other than the blade surface of the scissors is covered with an electrically insulating coating,
The high frequency for an endoscope according to any one of claims 1 to 9, wherein the blade surface is formed of a flat portion and an inclined portion that is notched so as to be inclined from the flat portion toward the other flange side. Cautery incision. The entirety of the pair of scissors is formed of a conductive metal, and the outer surface of the part other than the blade surface of the scissors is covered with an electrically insulating coating,
The high frequency cautery incision scissors for endoscope according to any one of claims 1 to 9, wherein the blade surfaces are formed in an arc shape in which the blade surfaces face each other. The entirety of the pair of scissors is formed of a conductive metal, and the outer surface of the part other than the blade surface of the scissors is covered with an electrically insulating coating,
The high-frequency cautery incision scissors for endoscope according to any one of claims 1 to 9, wherein the blade surface is formed on an inclined surface where the blade surfaces face each other. The entirety of the pair of scissors is formed of a conductive metal, and the outer surface of the part other than the blade surface of the scissors is covered with an electrically insulating coating,
The high-frequency cautery incision for endoscope according to any one of claims 1 to 9, wherein the blade surface is formed in an arc shape protruding in an opening / closing direction.

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