JP2016002402A - High frequency treatment device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a high frequency treatment device which improves stability of behavior of a treatment part while securing operability of suction operation, sending operation of liquids, or the like through a forceps hole for increasing a degree of accuracy of a technique in the high frequency treatment device used by being inserted in the forceps hole of an endoscope.SOLUTION: A high frequency treatment device is equipped with a sheath part 30, and is used by being inserted in a forceps hole of an endoscope. A projection part 36 (a projection part 36a, a projection part 36b, a projection part 36c) is provided partially in a circumferential direction on an outer peripheral surface of the sheath part 30. An outer peripheral surface (a recessed part 34a, a recessed part 34b, a recessed part 34c) excluding the projection part 36 forms a flow passage in an axial direction of the sheath part 30.

Description

  The present invention relates to a high-frequency treatment instrument.

  In recent years, attention has been focused on a surgical operation using an endoscope represented by endoscopic submucosal dissection (ESD). There are advantages that the burden on the subject during the operation is relatively small and the hospital stay can be shortened.

  In this type of surgery, a dedicated high-frequency treatment instrument is used together with an endoscope. A high-frequency treatment instrument is a treatment instrument that has a function of excising tissue by ablating at a treatment section energized by a high-frequency current, a function of stopping bleeding, and the like. Specifically, a high-frequency knife, a hot biopsy forceps, Examples include scissors forceps. The following Patent Document 1 is exemplified as this type of technology.

  Patent Document 1 discloses a high-frequency knife for performing an incision treatment by being inserted into a body cavity endoscopically. In this high-frequency knife, the distal end of the treatment portion is hemispherical and is formed to have a relatively large diameter, so that when the tissue is incised or separated, the distal end of the treatment portion is locked to the tissue or its periphery. Therefore, once the tip is buried in the tissue, it is fixed at the position where the tip of the high-frequency knife is buried.

JP 2010-42155 A

  While exhibiting the effects as described above, when the high-frequency knife is inserted into the forceps hole (working channel) of the endoscope, the diameter of the distal end member of the sheath portion is enlarged, so that the distal end member becomes the forceps hole. When it is located in the inner cavity of this, the forceps hole is almost blocked (see FIG. 6 of Patent Document 1). In this case, it is difficult to perform a bodily fluid suction operation or a drug solution feeding operation through the forceps hole.

Further, in the state where the distal end member of the sheath part protrudes from the forceps hole (see FIG. 10 of Patent Document 1), the distance (play) between the inner wall of the forceps hole and the outer peripheral surface of the sheath part increases. While suction operation and liquid feeding operation become easy, the following problems arise.
In surgical operations such as ESD, the distal end of the endoscope (treatment part) reaches the target living tissue by bending the distal end of the endoscope or by moving the sheath part of the high-frequency treatment tool forward and backward within the forceps hole. To remove the living tissue. At this time, if the play is large, the behavior of the treatment section is not stable, and a certain difficulty occurs in the procedure.

  The present invention has been made in view of the above problems, and is a high-frequency treatment instrument that is used by being inserted into a forceps hole of an endoscope, and has operability such as a suction operation and a liquid feeding operation through the forceps hole. Provided is a high-frequency treatment instrument that improves the stability of the behavior of the treatment section and enhances the accuracy of the procedure while ensuring.

  According to the present invention, a high-frequency treatment instrument that is used by being inserted into a forceps hole of an endoscope, is long and flexible, includes a lumen, and is inserted into the forceps hole. A sheath part; an operation part provided on a proximal end side of the sheath part; an operation wire that slides in the lumen of the sheath part in an axial direction by operation of the operation part; and the operation wire And a treatment part to which a high-frequency current is passed, and a convex part is provided in the circumferential direction of the outer peripheral surface of the sheath part, and the outer peripheral surface excluding the convex part is the There is provided a high-frequency treatment instrument that is a flow path of the sheath portion in the axial direction.

  According to the present invention, a high-frequency treatment tool that is used by being inserted into a forceps hole of an endoscope, and improves the stability of the behavior of the treatment portion while ensuring operability such as a suction operation through the forceps hole. Thus, a high-frequency treatment tool that improves the accuracy of the procedure is provided.

1 is an overall view of a high-frequency treatment tool according to an embodiment of the present invention. It is an enlarged view of the front-end | tip of a sheath part and a treatment tool. It is sectional drawing in the III-III cross section in FIG. It is sectional drawing in the IV-IV cross section in FIG. It is a schematic diagram which shows the vicinity of the insertion port in the forceps hole of an endoscope. It is a perspective view which shows the state which the front-end | tip (treatment part) of a sheath part protrudes from the front-end | tip of an endoscope.

Hereinafter, embodiments of the present invention will be described with reference to the drawings. In all the drawings, the same components are denoted by the same reference numerals, and description thereof will be omitted as appropriate.
FIG. 1 is an overall view of a high-frequency treatment device 100 according to an embodiment of the present invention. FIG. 2 is an enlarged view of the distal end of the sheath part 30 and the treatment part 40. 3 is a cross-sectional view taken along the line III-III in FIG. 4 is a cross-sectional view taken along the line IV-IV in FIG. FIG. 5 is a schematic diagram showing the vicinity of the insertion port 212 in the forceps hole 210 of the endoscope 200. FIG. 6 is a perspective view showing a state in which the distal end (treatment portion 40) of the sheath portion 30 protrudes from the distal end of the endoscope 200. FIG.
FIG. 6 shows an example in which a part of the forceps hole 210 is removed for the sake of convenience so that the inside of the forceps hole 210 can be seen.

<About the whole high frequency treatment instrument 100>
As shown in FIGS. 5 and 6, the high-frequency treatment instrument 100 is used by being inserted into a forceps hole 210 of the endoscope 200.
The sheath portion 30 is long and flexible, and includes a lumen 32 (see FIGS. 2 and 4), and is inserted through the forceps hole 210 (see FIGS. 5 and 6).
As shown in FIG. 1, the operation unit 10 is provided on the proximal end side of the sheath unit 30.
The operation wire 20 slides in the lumen 32 of the sheath portion 30 so as to advance and retract in the axial direction by the operation of the operation portion 10.
The treatment section 40 is provided at the distal end of the operation wire 20 and is energized with a high frequency current.
As shown in FIG. 3, the high-frequency treatment device 100 is provided with convex portions 36 (convex portions 36 a, convex portions 36 b, convex portions 36 c) partially in the circumferential direction of the outer peripheral surface of the sheath portion 30. The outer peripheral surface (recess 34a, recess 34b, recess 34c) excluding 36 is a flow path in the axial direction of the sheath part 30.

  Since it has the characteristics described in the previous stage, the interval (play) between the inner peripheral surface of the forceps hole 210 of the endoscope 200 and the outer peripheral surface of the sheath portion 30 is narrowed at the convex portion 36, so that the distal end of the sheath portion 30 (the treatment portion) 40) is stabilized, and the accuracy of the procedure using the high-frequency treatment instrument 100 is improved.

  Further, when performing a suction operation or a liquid feeding operation through the forceps hole 210 of the endoscope 200, the concave portion 34 (the concave portion 34a, the concave portion 34b, the concave portion 34c) functions as a flow path, and these operations are facilitated.

Here, the convex part 36 being partially provided on the outer peripheral surface means that the convex part 36 is provided in a range not extending over the entire circumference. In other words, in the cross section perpendicular to the axial direction of the sheath portion 30 (for example, the cross section shown in FIG. 3), the convex portion 36 and the concave portion 34 are mixed on the outer peripheral surface of the sheath portion 30.
Note that the convex portion 36 and the concave portion 34 are based on a comparison in height, and the concave portion 34 has the same height with respect to the other outer peripheral surface of the sheath portion 30 (the outer peripheral surface on the proximal end side from the terminal end portion 35). It may be any mode of being higher, higher and lower.

Here, the flow path refers to a space in which liquid or gas can flow, which is constituted by a gap between the outer peripheral surface of the sheath part 30 and the inner wall of the forceps hole 210 when the sheath part 30 is inserted into the forceps hole 210.
Here, the flow path in the axial direction of the sheath portion 30 includes a flow path that flows along the axial direction, and also includes a flow path that flows in an oblique direction with respect to the axial direction.

<About the operation unit 10>
The operation unit 10 is a member that adjusts the protruding length of the treatment unit 40 by moving the operation wire 20 in the sheath unit 30 forward and backward. The operation unit 10 includes a handle 12, a shaft 14, a slider 16, a power plug 18, and the like.
The handle 12 is a part gripped by the operator. The shaft portion 14 has a cylindrical shape. When the slider 16 is slid in the axial direction of the shaft portion 14, the operation wire 20 slides toward the distal end side or the proximal end side according to the movement of the slider 16. Yes. The power plug 18 is energized by being connected to a power cord (not shown), and can apply a high-frequency current to the treatment portion 40 via the operation wire 20.

<About the operation wire 20>
The operation wire 20 is a member that transmits the operation of the operation unit 10 (sliding motion of the slider 16) to the treatment unit 40.
Further, the operation wire 20 is a stranded wire of a plurality of metal wires, and functions as a high-frequency current feeding path to the treatment unit 40. Specifically, the operation wire 20 is a stranded wire of three or seven stainless steel materials. In each drawing, for convenience, the operation wire 20 is illustrated as having a circular cross section.
By forming the operation wire 20 with a plurality of metal wires, there is an effect that the high-frequency current is not interrupted even if some of the metal wires are broken. In addition, since the operation wire 20 is a stranded wire, the slidability is high, and friction when the lumen 32 of the sheath portion 30 is advanced and retracted is reduced.

The length of the operation wire 20 is determined such that it protrudes from the distal end of the sheath portion 30 when the slider 16 is slid to the most distal end side.
Further, the outer diameter of the operation wire 20 is determined to be smaller than the inner diameter of the sheath portion 30, and specifically, 0.39 mm.

<About the sheath part 30>
The sheath portion 30 is a member that covers the operation wire 20 and the treatment portion 40 and protects them.
The sheath portion 30 is made of a resin material, and other materials may be mixed. More specifically, one or more kinds of flexible materials such as fluorine resin, polyolefin resin, polyamide resin, polyimide resin, polyurethane resin, polycarbonate resin, etc. are appropriately selected and adopted. Is possible. The sheath part 30 of this embodiment is formed of polytetrafluoroethylene (PTFE: polytetrafluoroethylene).
In addition, the sheath portion 30 preferably has an insulating property because a high-frequency current is passed through the operation wire 20 and the treatment portion 40 existing in the lumen 32 thereof.

The length of the sheath part 30 may vary depending on the length of the forceps hole 210 of the endoscope 200 used with the high-frequency treatment instrument 100, but is preferably in the range of, for example, 1500 mm or more and 2500 mm or less. The length of the sheath part 30 in this embodiment is 1950 mm.
The outer diameter of the sheath part 30 may vary depending on the inner diameter of the forceps hole 210 of the endoscope 200 used together with the high-frequency treatment instrument 100, but is 2 mm or more, for example, at the maximum position (tip position of the convex part 36). It is preferably in the range of 3 mm or less. Moreover, it is preferable that the outer diameter of the sheath part 30 exists in the range of 1.5 mm or more and 2 mm or less in the minimum location (bottom surface of the recessed part 34), for example. The outer diameter of the sheath portion 30 in the present embodiment is 2.65 mm at the maximum location and 1.80 mm at the minimum location.
The inner diameter of the sheath portion 30 may vary depending on the outer diameter of the operation wire 20 and the size of the treatment portion 40, or the outer diameter of the sheath portion 30, but is in the range of, for example, 0.7 mm or more and 1.5 mm or less. It is preferable that it exists in. The inner diameter of the sheath part 30 in this embodiment is 0.90 mm.
In addition, the dimension of the sheath part 30 quoted by this paragraph is shown as an example, and an embodiment is not limited to the dimension quoted here.

  The inner diameter of the forceps hole 210 varies depending on the endoscope 200, but three types of 3.7 mm, 3.2 mm, and 2.8 mm are generally used. In the present embodiment, the dimensions of the high-frequency treatment instrument 100 (sheath portion 30) are determined on the assumption that the forceps hole 210 having an inner diameter of 3.2 mm is inserted and used.

  As shown in FIG. 5, the sheath portion 30 is inserted from an insertion port 212 provided in the middle of the forceps hole 210. The diameter of the insertion port 212 is equal to or slightly smaller than the outer diameter of the sheath portion 30, and the periphery of the insertion port 212 is a rubber plug 214. Therefore, when the sheath portion 30 is inserted into the insertion port 212, water tightness Is secured.

A suction port 216 is provided in the middle of the forceps hole 210 in addition to the insertion port 212. By operating a suction device (not shown) connected to the suction port 216, a body fluid or the like can be obtained through the forceps hole 210. Suction is possible.
Although not shown here, the proximal end side of the forceps hole 210 is closed, and suction is performed exclusively from the distal end side when performing a suction operation. In addition, a mouth for feeding or feeding air may be provided in the middle of the forceps hole 210, and a liquid feeding (air feeding) operation of a drug solution or the like can be performed via the forceps hole 210. Also good.

As shown in FIG. 2 and the like, the convex portion 36 is formed in a streak shape in the axial direction of the sheath portion 30. That is, since the convex portion 36 is continuously connected, friction generated between the convex portion 36 and the inner wall of the forceps hole 210 when the sheath portion 30 advances and retracts is reduced, and the operability of the sheath portion 30 for advancing and retracting is improved. Will improve.
Here, the streak refers to a shape that is elongated and continuous.

  In this embodiment, although the convex part 36 is demonstrated so that it may continue in a row along the axial direction of the sheath part 30, this is one aspect | mode, and this invention is not limited to this aspect. For example, the convex part 36 may be divided | segmented into plurality. That is, one convex portion 36 and the other convex portion 36 may have a gap in the axial direction. Further, the plurality of convex portions 36 do not have to be regularly arranged along the axial direction, and may be irregularly arranged. Further, it is not necessary that the continuous convex portions 36 are along the axial direction, and a mode in which the convex portions 36 are spirally wound around the outer peripheral surface of the sheath portion 30 may be employed.

  Further, as shown in FIG. 2 and the like, in the sheath portion 30 of the present embodiment, a plurality of convex portions 36 are provided, and the concave portions 34 between the respective convex portions 36 (the convex portions 36a, the convex portions 36b, and the convex portions 36c). (Recess 34a, recess 34b, recess 34c) are formed in a groove shape. Thereby, when a suction operation or a liquid feeding operation is performed, the flow direction of the flowing body fluid or chemical solution is determined, so that the fluidity is improved.

Here, the concave portion 34 refers to a portion that is recessed from the tip of the convex portion 36 in the protruding direction.
In the present embodiment, the recess 34 is described as being formed in a groove shape along the axial direction, but this is one aspect, and the present invention is not limited to this aspect. For example, the recess 34 may be a groove that spirals around the outer peripheral surface of the sheath portion 30.

As shown in FIG. 3, the convex portion 36 projects outward in the radial direction around the central axis of the sheath portion 30. Further, in the vertical cross section (transverse cross section) with respect to the axial direction of the sheath portion 30, the convex portions 36 are arranged at substantially equal angles around the central axis of the sheath portion 30. Here, it is preferable that the protrusion height from the outer peripheral surface of each convex portion 36 is substantially uniform from the central axis.
In the present embodiment, the three convex portions 36 (the convex portion 36a, the convex portion 36b, and the convex portion 36c) are arranged every 120 degrees around the central axis, and three concave portions 34 (the concave portion 34a, the concave portion 34b) are arranged therebetween. 34b and recess 34c) are formed.
With this configuration, the contact between the sheath portion 30 and the inner peripheral surface of the forceps hole 210 can be evenly distributed to each of the convex portion 36a, the convex portion 36b, and the convex portion 36c, and the sheath portion 30 can be smoothly advanced and retracted. become.

As shown in FIG. 6, in the sheath portion 30 of the present embodiment, the convex portion 36 is provided from the distal end of the sheath portion 30 to the end portion 35. That is, the convex portion 36 is locally provided at the distal end portion of the sheath portion 30. More specifically, the convex part 36 is limited to a predetermined distance from the most distal end of the sheath part 30, and the predetermined distance is larger than the length in the longitudinal direction of the accommodation tip 38 (see FIG. 4). The accommodation chip 38 will be described in detail later.
As a result, the contact surface between the sheath part 30 (convex part 36) and the inner wall of the forceps hole 210 is limited, so that the friction is reduced and the sheath part 30 can be easily advanced and retracted. And about the part which does not provide the convex part 36, since the area of the flow path formed with the outer peripheral surface of the sheath part 30 and the inner wall of the forceps hole 210 becomes comparatively large, suction operation etc. via the forceps hole 210 etc. The operability is improved. Moreover, since the convex part 36 is provided in the front-end | tip part (around the accommodating chip | tip 38) of the sheath part 30, the effect which stabilizes the behavior of the front-end | tip (treatment part 40) of the sheath part 30 is not impaired.

In the application of the high-frequency treatment instrument 100 of the present embodiment, it is sufficient that the length of the convex portion 36 is 100 mm. This dimension allows a general length that the sheath portion 30 protrudes from the forceps hole 210 during the procedure, so that a part of the convex portion 36 is left inside the forceps hole 210. Therefore, the behavior of the treatment unit 40 can be stabilized at all times during the procedure.
However, depending on the case, the aspect in which the convex part 36 of the length exceeding the dimension shown by this paragraph may be taken.

  The outer diameter of the base end side of the sheath part 30 where the convex part 36 is not provided is preferably set to the same size as the minimum outer diameter (the outer diameter of the concave part 34) at the part where the convex part 36 is provided. . Therefore, in this embodiment, the outer diameter of the base end side of the sheath part 30 is 1.80 mm.

As shown in FIG. 3, the tip of the protruding portion 36 in the protruding direction is preferably blunt. More specifically, the tip in the protruding direction of the convex portion 36 of the present embodiment has an arc shape with a 1.8 mm diameter in cross section.
Thereby, when the convex part 36 contact | abuts to the internal peripheral surface and biological tissue of the forceps hole 210, it becomes difficult to give a damage.

<About the treatment part 40 and the vicinity of the treatment part 40>
The treatment section 40 is a member that generates high heat when applied with a high-frequency current and excises or stops hemostasis by cauterizing a target living tissue. The treatment part 40 includes a substantially spherical tip part 41 and a needle-like needle part 42.
The treatment portion 40 is formed of a highly conductive stainless steel material or the like. Moreover, although the shape of the front-end | tip part 41 is illustrated as substantially spherical shape in this embodiment, it is not limited to this, Various shapes can be taken according to the use. For example, the tip 41 may be blade-shaped, scissors-shaped, or cup-shaped.

As shown in FIG. 6, the treatment section 40 is used by projecting from a projecting opening 218 provided on the distal end side of the forceps hole 210. In addition to the projection port 218, an objective lens 220, a light guide 232, and a light guide 234 are provided at the distal end of the endoscope 200.
The objective lens 220 is a lens of a microminiature camera, and can image an organ state. The light guide 232 and the light guide 234 can irradiate the body with light from a light source (not shown) built in the endoscope 200.

As shown in FIG. 4, the treatment portion 40 protrudes from the through hole 38 a of the accommodation chip 38. The accommodation chip 38 has a circular through hole 38 a in the axial direction and is press-fitted into the distal end side of the sheath portion 30.
As described above, the distal end portion 41 (the distal end of the treatment portion 40) is formed in a substantially spherical shape, and when the treatment portion 40 is advanced and retracted in the through hole 38a, friction is caused between the inner wall of the through hole 38a and the distal end portion 41. It has been adjusted to occur.
Accordingly, when the treatment portion 40 is advanced and positioned in the through hole 38a, the treatment portion 40 is decelerated due to the friction, so that the treatment portion 40 can be prevented from suddenly protruding from the through hole 38a of the accommodation chip 38. Therefore, it is possible to reduce the occurrence rate of erroneous operations such as causing the treatment unit 40 to accidentally come into contact with the living tissue, and to improve the accuracy of the procedure using the high-frequency treatment tool 100.

The housing tip 38 is a member for housing the treatment section 40 in the sheath section 30 except when in use (when the slider 16 is slid to the distal end side). Since the accommodation chip 38 comes into contact with the treatment portion 40 that is heated by being applied with a high-frequency current, it is formed of a material having excellent insulation and heat resistance. Note that the accommodation chip 38 of the present embodiment is made of ceramic.
Since the housing tip 38 has higher rigidity than the sheath portion 30, the sheath portion 30 is difficult to bend around the housing tip 38. As described above, the length of the convex portion 36 exceeds the length of the housing chip 38 in the longitudinal direction, and play is reduced at least around the housing chip 38 that is difficult to bend. In addition, the length of the longitudinal direction of the accommodation chip | tip 38 of this embodiment is about 10 mm.
In addition, since the accommodation tip 38 of the present embodiment has the configuration described in the previous stage, the outer diameter thereof is substantially equal to the inner diameter of the sheath portion 30, and the inner diameter (the inner diameter of the through hole 38 a) is the outer diameter of the tip portion 41. It is almost equal.

The inner peripheral surface on the distal end side of the sheath portion 30 is threaded, and the outer peripheral surface of the accommodation tip 38 (accommodating tip) is in contact with the inner peripheral surface subjected to the threading processing.
As a result, strong friction is generated with respect to the sheath part 30 being pulled out in the axial direction, so that the receiving tip 38 is difficult to be removed from the sheath part 30. Further, since the flexible sheath portion 30 is threaded, it is easier than threading the housing tip 38.

In addition, a stopper 22 having a diameter larger than the inner diameter of the through hole 38 a is provided in the middle of the operation wire 20. More specifically, a cylindrical stopper 22 is fixed in the middle of the operation wire 20, and when the operation wire 20 has advanced to the distal end side to some extent, the surface on the distal end side of the stopper 22 is located on the proximal end side of the accommodation chip 38. It is comprised so that it may contact | abut on a surface.
With this configuration, when the stopper 22 abuts on the accommodation tip 38, further progression of the operation wire 20 is restricted, so that the length of the treatment portion 40 protruding from the distal end of the sheath portion 30 (accommodation tip 38) is increased. It can be kept below a certain level. Therefore, since the treatment part 40 is prevented from protruding with an unexpected length, the accuracy of the procedure using the high-frequency treatment tool 100 can be improved. In addition, in the high frequency treatment tool 100 in this embodiment, the maximum protrusion length of the treatment part 40 is about 17 mm.

The stopper 22 is provided in the middle of the operation wire 20 and has a larger diameter than the diameter of the operation wire 20, and thus functions as a centering member for the operation wire 20.
Here, the centering member is a member having a function of bringing the central axis of the operation wire 20 close to the central axis of the sheath portion 30. If the center axis of the operation wire 20 and the center axis of the sheath portion 30 are deviated, the path of the operation wire 20 extending to the lumen 32 becomes shorter than the path of the sheath portion 30 when the sheath portion 30 is refracted. In some cases, the distal end of the operation wire 20 may unexpectedly jump out of the distal end of the sheath portion 30. The centering member is provided to prevent this.

  As described so far, since the high-frequency treatment instrument 100 of the present invention has various contrivances for each component, it ensures operability such as a suction operation through the forceps hole 210 of the endoscope 200. The stability of the behavior of the treatment section 40 can be improved, and the accuracy of the procedure using the high-frequency treatment instrument 100 can be increased.

  The various components of the high-frequency treatment device 100 of the present invention do not have to be individually independent, but a plurality of components are formed as a single member, and a single component is formed of a plurality of members. That a certain component is a part of another component, a part of a certain component overlaps a part of another component, and the like.

This embodiment includes the following technical ideas.
(1) A high-frequency treatment instrument used by being inserted into a forceps hole of an endoscope, which is long and flexible, includes a lumen, and has a sheath portion inserted into the forceps hole; An operation portion provided on a proximal end side of the sheath portion, an operation wire that slides in an axial direction in the lumen of the sheath portion by operation of the operation portion, and a distal end of the operation wire Provided with a treatment part to which a high-frequency current is applied, and a convex part is provided in the circumferential direction of the outer peripheral surface of the sheath part, and the outer peripheral surface excluding the convex part is provided on the sheath part. A high-frequency treatment instrument that is a flow path in the axial direction.
(2) The high frequency treatment device according to (1), wherein the convex portion is formed in a streak shape in the axial direction of the sheath portion.
(3) The high frequency treatment device according to (2), wherein a plurality of the convex portions are provided, and the concave portions between the convex portions are formed in a groove shape.
(4) The high frequency treatment instrument according to (3), wherein the convex portion projects outward in the radial direction with the central axis of the sheath portion as a center.
(5) In the vertical cross section with respect to the axial direction, the convex portions are arranged at substantially equal angles with the central axis as the center, and the protruding heights of the convex portions from the outer peripheral surface are substantially uniform. The high-frequency treatment tool according to (4).
(6) The high-frequency treatment instrument according to any one of (1) to (5), wherein the convex portion is locally provided at a distal end portion of the sheath portion.
(7) The high-frequency treatment tool according to any one of (1) to (6), wherein a tip of the protruding portion in the protruding direction is blunt.
(8) It is provided with an accommodation tip having a circular through-hole in the axial direction, the accommodation tip is press-fitted to the distal end side of the sheath portion, and the distal end of the treatment portion is formed in a substantially spherical shape, The high frequency according to any one of (1) to (7), wherein friction is generated between an inner wall of the through hole and the tip of the treatment portion when the treatment portion is advanced and retracted in the through hole of the accommodation chip. Treatment tool.
(9) The high-frequency treatment according to (8), wherein the convex portion is formed so as to be limited to a predetermined distance from the most distal end of the sheath portion, and the predetermined distance is larger than a length in a longitudinal direction of the housing chip. Ingredients.
(10) The high-frequency treatment instrument according to (8) or (9), wherein a stopper having a diameter larger than the inner diameter of the through hole is provided in the middle of the operation wire.
(11) The inner peripheral surface on the distal end side of the sheath portion is threaded, and the outer peripheral surface of the accommodation tip is in contact with the inner peripheral surface subjected to the threading (8). To (10) The high-frequency treatment device according to any one of (10).
(12) The high-frequency treatment instrument according to any one of (1) to (11), wherein the operation wire is a stranded wire of a plurality of metal wires and functions as a feeding path for the high-frequency current to the treatment portion. .

DESCRIPTION OF SYMBOLS 100 High frequency treatment tool 10 Operation part 12 Handle 14 Shaft part 16 Slider 18 Power plug 20 Operation wire 22 Stopper 30 Sheath part 32 Lumen 34 (34a, 34b, 34c) Concave part 36 (36a, 36b, 36c) Convex part 35 Termination part 38 Accommodating tip 38a Through-hole 40 Treatment part 41 Tip part 42 Needle-like part 200 Endoscope 210 Forceps hole 212 Insertion port 214 Rubber plug 216 Suction port 218 Projection port 220 Objective lenses 232 and 234 Light guide

Claims (12)

A high-frequency treatment instrument used by being inserted into a forceps hole of an endoscope,
A long and flexible sheath containing a lumen and inserted through the forceps hole;
An operating portion provided on the proximal end side of the sheath portion;
An operation wire that slides in the axial direction in the lumen of the sheath portion so as to freely advance and retreat by operation of the operation portion;
A treatment section provided at the tip of the operation wire and energized with a high-frequency current,
A high-frequency treatment instrument in which a convex portion is partially provided in a circumferential direction of the outer peripheral surface of the sheath portion, and the outer peripheral surface excluding the convex portion serves as a flow path in the axial direction of the sheath portion.   The high-frequency treatment tool according to claim 1, wherein the convex portion is formed in a streak shape in the axial direction of the sheath portion. A plurality of the convex portions are provided,
The high frequency treatment tool according to claim 2, wherein a concave portion between the convex portions is formed in a groove shape.   The high-frequency treatment instrument according to claim 3, wherein the convex portion projects outward in the radial direction about the central axis of the sheath portion.   In the vertical cross section with respect to the axial direction, the convex portions are arranged at substantially equal angles around the central axis, and the protruding heights of the convex portions from the outer peripheral surface are substantially uniform. Item 5. The high-frequency treatment tool according to Item 4.   The high-frequency treatment instrument according to any one of claims 1 to 5, wherein the convex portion is locally provided at a distal end portion of the sheath portion.   The high-frequency treatment tool according to any one of claims 1 to 6, wherein a tip of the protruding portion in a protruding direction is blunt. A housing chip having a circular through hole vacant in the axial direction,
The accommodation tip is press-fitted to the distal end side of the sheath part,
The distal end of the treatment portion is formed in a substantially spherical shape,
The high frequency treatment according to any one of claims 1 to 7, wherein friction is generated between an inner wall of the through hole and the distal end of the treatment portion when the treatment portion is advanced and retracted in the through hole of the accommodation chip. Ingredients.   The high-frequency treatment tool according to claim 8, wherein the convex portion is formed so as to be limited to a predetermined distance from the foremost end of the sheath portion, and the predetermined distance is larger than a length in a longitudinal direction of the housing tip.   The high-frequency treatment tool according to claim 8 or 9, wherein a stopper having a diameter larger than the inner diameter of the through hole is provided in the middle of the operation wire. The inner peripheral surface on the distal end side of the sheath portion is threaded,
The high frequency treatment tool according to any one of claims 8 to 10, wherein an outer peripheral surface of the receiving chip is in contact with the inner peripheral surface on which the threading process has been performed.   The high-frequency treatment tool according to any one of claims 1 to 11, wherein the operation wire is a stranded wire of a plurality of metal wires and functions as a feeding path for the high-frequency current to the treatment portion.

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