JP2018068474A - Treatment instrument for endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To rotationally turn a treatment part in synchronization with rotational turning of an operation wire.SOLUTION: A treatment instrument for endoscopes in which a coil sheath 31 and an operation wire 32 independently, rotationally turn about a shaft at a tip side, includes: the coil sheath 31, the tip end of which is ground such that the diameter of a tip end side is reduced; a pair of half-split rings 43 that are welded such that a diameter of an opening part is reduced in a state where the tip end of the coil sheath to which a circular ring 42 is welded is inserted into the opening part; and a ring 42 that is welded to the tip end of the coil sheath 31 and whose coming-off is prevented by the half-split rings 43.SELECTED DRAWING: Figure 3

Description

  The present invention relates to an endoscopic treatment tool used in an endoscopic system for treating a living tissue by being inserted into a body cavity of a living body.

  In general, an endoscope system is widely used as a means for performing direct diagnosis and treatment of a lesion site in the body with minimal invasiveness, and an endoscope having a treatment unit for performing treatment within the field of view of the endoscope system. A treatment instrument is inserted through the channel of the endoscope.

  The endoscope treatment tool includes a treatment part for performing a treatment such as excision of an affected part, an operation part for performing an operation of the treatment tool (opening and closing in the case of a wrinkle or a cup), and the treatment part and operation. An operation wire for connecting the parts, and a sheath made of a flexible material that covers the operation wire between the treatment part and the operation part.

  It is desirable for the endoscope treatment tool configured as described above to be able to arbitrarily change the direction of the distal treatment section from the hand side in accordance with the state of the affected part in the living body lumen.

  The following patent document is cited as a document describing a technique related to a treatment instrument for an endoscope according to the prior art, and in this patent document, a flexible wire having a greater rotational followability than a flexible sheath as an operation wire. , And a flexible sheath and an operation wire that rotate integrally around the axis on the proximal end side and independently rotate around the axis on the distal end side Is described.

JP 2007-289593 A

According to the invention described in Patent Document 1, with the above configuration, when the flexible sheath and the operation wire are rotated around the axis by the operation unit on the hand side, the sheath does not rotate in the endoscope channel. Since the operation wire rotates, the treatment portion at the tip can be rotated around the axis. However, the endoscope treatment tool described in Patent Document 1 has a flexible sheath and an endoscope in a portion located in the curved portion near the distal end of the endoscope insertion portion that is largely bent with a small radius of curvature. Since the resistance to relative rotational motion around the axis between the channel and the channel is large, the rotational force applied to the flexible sheath on the hand side is greatly absorbed in the bending portion, and the rotational motion is smoothly transmitted to the tip side. It is difficult to rotate the treatment portion in synchronization with the rotation of the operation wire.

In particular, when the endoscope treatment tool according to the prior art is bent many times in the living body lumen, the coil sheath is pushed or pushed out to the operation unit side with respect to the support frame supporting the treatment tool. There is also a problem that it is difficult to smoothly rotate the treatment instrument due to the frictional resistance between the inner wall of the support frame in the operation wire axial direction and the metal fitting provided at the end of the operation wire.

  The present invention has been made in order to solve the above-mentioned problems, and has as its main object to provide an endoscopic treatment tool capable of rotating a treatment section in synchronization with rotation of an operation wire. To do.

  To achieve the above object, the present invention provides a flexible long cylindrical coil sheath in which a metal material is tightly wound, an operation wire disposed in the coil sheath so as to be capable of moving back and forth in the longitudinal direction, the operation wire, The control unit is attached to the proximal end side of the coil sheath, and has an operation unit for moving the operation wire forward and backward in the coil sheath, a treatment unit for treating a living tissue, and a pair of arms that support the treatment unit, and An endoscopic treatment tool having an opening for inserting the distal end side of the operation wire, and a distal end support means for connecting the distal end of the operation wire to the treatment portion, wherein the distal end side is reduced in diameter. The coil sheath that has been ground, the ring that is welded to the tip of the coil sheath and that has a larger diameter than the diameter reduced by the slip-off prevention member, and the tip of the coil sheath to which the ring is welded to the tip And welded off preventing member to diameter opening diameter of the state inserted into the opening part, in that it comprises a first feature.

According to the second aspect of the present invention, in the endoscope treatment tool according to the first feature, a ring outer peripheral surface in contact with an inner wall of the opening of the distal end support means is formed in a circular arc shape. In the endoscope treatment instrument having any one of the above characteristics, a third feature is that the removal preventing member surface in contact with the outer periphery of the coil sheath has an arcuate cross section, and the endoscope having any one of the above characteristics In the treatment instrument, a fourth feature is that at least a distal end portion of the coil sheath is coated with an alloy.

  The endoscope treatment tool according to the present invention can rotate the treatment portion in synchronization with the rotation of the operation wire.

The figure for demonstrating the endoscope system containing the treatment tool for endoscopes by this invention. 1 is an overall view of an endoscope treatment tool according to an embodiment of the present invention. FIG. The expanded sectional view of the front-end | tip part of the treatment tool for endoscopes by a present Example. The figure for demonstrating the manufacturing method of the treatment tool for endoscopes by a present Example. The perspective view of the front-end | tip part of the treatment tool for endoscopes by a present Example. The figure for demonstrating a connection structure with the operation wire using the support frame main body by a present Example. The figure for demonstrating a connection structure with the operation wire using the support frame main body by the other Example of this invention.

  Hereinafter, an endoscope treatment tool according to an embodiment of the present invention will be described. First, an entire endoscope system to which the endoscope treatment tool according to the present embodiment is applied will be described.

[Endoscope system]
As shown in FIG. 1, an endoscope system 1 to which an endoscope treatment tool 30 according to this embodiment is applied includes an insertion portion 11 for insertion into a body cavity of a living body, and a distal end of the insertion portion 11. An operation part 10 having a dial for bending up, down, left and right is provided, and is formed in the longitudinal direction from the treatment instrument introduction part 12 disposed between the insertion part 11 and the operation part 10 toward the distal end of the insertion part 11. An endoscope channel 1a that is a hole is formed, and a treatment portion 33 and a coil sheath 31 of an endoscope treatment tool 30 (to be described later) are inserted into the endoscope channel 1a.

[Endoscope treatment tool]
The endoscope treatment tool 30 according to the present embodiment is disposed on the distal end side as shown in FIG. 2 showing the entire structure and FIG. 3 showing an enlarged sectional view of the distal end, and is pivotally supported by the link mechanism to be in an open state and a closed state. A treatment portion 33 having a pair of hook pieces 36a and 36b that are pivotally displaced to each other, an operation portion 34 that is disposed on the proximal end side and capable of pulling the operation wire 32 to the proximal end side, and the treatment portion 33 and the operation portion. 34, and a flexible long cylindrical coil sheath 31 in which a metal material such as a stainless steel wire is tightly wound, and the coil sheath 31 between the treatment section 33 and the operation section 34 can be moved back and forth loosely. And an operation wire 32 corresponding to an operation means made of a torque wire which is arranged and is conductive and has a large follow-up performance.

  As shown in FIG. 3, the distal end portion of the endoscope treatment tool 30 according to the present embodiment is a distal end support means for supporting the treatment portion 33, and a cylindrical shape in which the distal end portion of the coil sheath 31 is inserted on the rear end side. The support frame main body 41a provided with a wire insertion hole 41f for inserting the opening 41e and the operation wire 32, and a pair of arms 41b and 41c extending from the support frame main body 41a in the distal direction to support the treatment portion 33. And a pair of flanges 36a and 36b that are pivotally supported by a pivot shaft 35 that extends between the arms of the tip support frame 41 and pivotally displaced between an open state and a closed state.

  The pair of flanges 36a and 36b are made of a conductive metal having a curved portion with a blade surface extending substantially linearly from the rear end toward the tip, and the tip curved in the inner surface direction (closing direction). Further, the flange piece 36a or 36b is pivotally supported by the shaft 37a or 37b on the distal end side of the link 38a or 38b on the rear end side with respect to the rotation shaft 35, and the rear ends of the links 38a and 38b. The side is attached to a metal fitting 38c which is a wire connecting member attached to the operation wire 32.

  The tip support frame 41 has a coil sheath 31 in which an annular ring 42 is fitted and laser welded to the tip ground so that the tip is reduced in diameter, and is inserted into the opening 41e at the rear end of the support frame main body 41a. A pair of half rings 43 for preventing the 42 and the coil sheath 31 from coming off from the support frame main body 41a are vertically arranged and laser-welded. The half ring 43 is obtained by cutting an annular ring into less than a half circle, and is formed so as to have an arc shape so that the cut surface protrudes perpendicularly to the cut surface. Yes. Further, the slip-off preventing member for the coil sheath 31 according to the present invention is not limited to a pair of half-rings. For example, a ring-shaped slip-off preventing member to be described later, such as a single half ring or a member having a polygonal cross section. There may be. 3 shows an example in which the inner ring wall of the ring 42 has a concave shape, the inner ring wall inner ring wall shape of the ring 42 according to the present invention is not limited to this, but an arc shape or a rectangular shape. Other shapes may be used.

  As shown in FIG. 2, the operation unit 34 relatively slides (advances and retracts) a slider 34b attached to the proximal end of the operation wire and an operation unit main body 34a attached to the proximal end of the coil sheath 31. As a result, the operation wire 32 can be moved in the longitudinal direction, and the slider 34b is moved in the left direction (tip side) in the drawing to move the operation wire 32 to the tip side and open the links 38a and 38b. When the distal ends of the flanges 36a and 36b connected to the rear ends of the links 38a and 38b are opened about the rotation shaft 35, and the operation wire 32 is moved in the right direction (base end side) in the drawing, the link 38a And 38b are closed, the tips of the hooks 36a and 36b are closed, and the affected part is incised.

  The endoscopic treatment tool 30 can incise the living tissue in contact with the scissors 36a and 36b while cauterizing the living tissue by applying a high-frequency current to the scissors 36a and 36b through the operation wire 32. For example, the incision may be made by the shearing force of the scissors without using a high-frequency current. In this embodiment, an example of opening and closing using the link mechanism including the links 38a and 38b has been shown. However, the opening and closing mechanism is not limited to that shown in this embodiment, and may be opened and closed by another mechanism. May be. Moreover, the treatment part applied to the endoscope treatment tool according to the present invention is not limited to the saddle type, and may be another treatment part such as forceps.

  Thus, in the endoscope treatment tool 30 according to the present embodiment, the ring 42 fitted and laser welded to the coil sheath 31 whose tip is ground to have a reduced diameter is formed so that the opening 41e of the support frame main body 41a is reduced in diameter. A pair of halved rings 43 laser-welded to each other constitutes a slip-off preventing member so that the coil sheath 31 is prevented from slipping out in the longitudinal direction.

  Further, the outer peripheral surface of the ring 42 is formed in an arc shape so as to make an arc contact with the inner wall of the opening 41e of the support frame main body 41a, and the half end surfaces of the pair of half rings 43 are formed in an arc shape and contracted. The outer periphery of the coil sheath 31 having a diameter is configured to be in arc contact. For this reason, the endoscope treatment tool 30 according to the present embodiment allows the distal end support frame 41 with the treatment portion 33 attached to the coil sheath 31 to be rotatable, and both of them (the coil sheath 31 and the support). Since the contact portion of the frame main body 41a) is configured to make an arc contact, the contact resistance is small and the rotation resistance can be reduced.

[assembly]
Next, a method for assembling and manufacturing the endoscope treatment tool 30 according to the present embodiment configured as described above will be described.
[Tip processing of coil sheath 31]
The coil sheath 31 applied to the present embodiment has a flexibility in which a metal material such as a stainless steel wire is tightly wound, and has an insertion length and a half split with respect to the distal end portion to be inserted into the support frame main body 41a. An end dimension portion less than the total width of the ring 43 is ground (or polished) to the extent of a coil pipe radius to reduce the diameter, and an alloy having a melting point lower than that of the coil on the ground portion and the coil surface adjacent to the ground portion. By coating the (brazing) material, the strength of the coil sheath 31 can be reinforced so as to be a predetermined value or more and the surface can be lubricated. The tip processing of the coil sheath 31 is not limited to the above-described method, and after reducing the tip diameter, the laser beam is irradiated to reinforce the strength to a predetermined value or more, and the surface is lubricated. You may make it process into. Further, the above-described silver row coating and laser processing may be combined, and the method of performing laser processing after the silver row coating is to improve the strength by altering a part of the silver row.

[Ring 42 and half ring 43]
The ring 42 attached to the tip of the operation wire 32 according to the present embodiment is formed so that the outer peripheral surface has an arcuate cross section, and the half ring 43 used as a retaining material for the operation wire 32 is a semicircular ring. In particular, the ring-shaped cut surface is formed in a circular arc shape. The reason why the outer peripheral surface of the ring 42 and the circular cut surface of the half ring 43 are formed in an arc shape is to reduce the contact resistance with the contacting member, and may have other structures, For example, a structure in which the vertexes of a polygon come into contact with each other may be used.

[assembly]
Next, a method for assembling and manufacturing the distal end portion of the endoscope treatment tool 30 according to this embodiment will be described.
This assembly manufacturing procedure is as follows.

  (1) As shown in FIG. 4A, an annular ring 42 is fitted into the tip of the coil sheath 31 whose tip is reduced in diameter and the surface is processed to be reinforced and lubricated, and as shown in FIG. A first step in which a silver brazing material is melted and coated on the tip of the coil sheath 31, and a laser beam is spot-irradiated to a plurality of locations on the surface of the silver brazing material to ensure hardness, and then the ring 42 is fixed by laser welding. This laser welding is, for example, a first step in which an alloy such as silver solder is applied to the inner circumferential portion of the ring 42 indicated by the symbol M in the drawing. This first step may be changed to laser light irradiation or silver low coating and laser light irradiation.

  (2) Next, as shown by arrow B in FIG. 4B, a second step of inserting the coil sheath 31 with the ring 42 fixed to the tip in the first step into the opening 41e of the support frame main body 41a.

  (3) Next, as shown in FIG. 4 (c), a pair of halves as shown in FIG. 4 (d) from the vertical direction of the opening 41e of the support frame main body 41a with the tip of the coil sheath 31 inserted. A third step of positioning the ring 43 and welding the pair of halved rings 43 at the position indicated by the arrow N by laser welding in the same manner as described above.

  Through this assembly manufacturing process, the endoscope treatment tool 30 according to the present embodiment prevents the ring 42 at the distal end of the coil sheath 31 from being detached from the distal end support frame 41 by the half ring 43 on the opening side, and the coil sheath 31 and the distal end. The support frame 41 can be relatively pivotably connected with reduced contact resistance.

  In the manufacturing process according to this embodiment, in the above-described embodiment, the ring 42 is laser welded to the tip of the coil sheath 31 and then inserted into the support frame body, and then the half ring is laser-laminated at the opening 41e of the support frame body. Although an example of welding has been described, the present embodiment is not limited to this. A tip ring attached to the unwelded operation wire tip and an annular diameter reducing ring for reducing the diameter of the opening of the support frame main body are provided as a coil sheath. In this inserted state, the reduced diameter ring is laser welded through the through hole of the operation wire on the distal end side of the support frame body and the reduced diameter ring is laser welded to the opening of the support frame body. You may comprise so that laser welding may be carried out to the metal fitting which penetrates an operation wire and is connected to a treatment tool.

  In particular, the endoscope treatment tool 30 according to the present embodiment has a silver brazing material 8 applied to the surface of the distal end portion (grinding portion and coil pipe) of the coil sheath 31 as shown in FIG. 6 in which the connecting structure portion of FIG. 4 is enlarged. Since the inner peripheral surface of the half ring 43 and the outer peripheral surface of the ring 42 are formed in an arc shape, the contact portion S between the distal end portion of the coil sheath 31 and the support frame main body 41a is formed. Contact resistance can be reduced.

  In particular, the endoscopic treatment tool 30 according to the present embodiment is bent many times in the living body lumen and the coil sheath 31 is moved in the direction of the arrow X in FIG. Since the contact area between the inner wall on the axial direction side and the side surface of the ring 42 decreases as an arc apex, the contact resistance between them can be reduced.

  In this embodiment, the example in which the inner peripheral surface of the half ring and the outer peripheral surface of the ring are formed in an arc shape has been described. However, the present invention is not limited to this, and as shown in FIG. May be configured to further reduce the contact resistance between them by using a half ring 43a having a triangular cross section and a ring 42a having an outer peripheral cross section. You may comprise in circular arc shape, a polygonal cross-sectional shape, etc.

  Further, in the above-described embodiment, the example using the sheath coil wound with the metal member material having a perfect circular cross section has been described. However, the sheath coil used for the endoscope treatment tool 30 according to the present invention is limited to the shape. Instead, for example, the cross-section of the metal member material may be a rectangular coil shape. Since this flat coil has a flat outer diameter portion and inner diameter portion of the coil sheath, the strength can be improved.

  Thus, in the endoscope treatment tool 30 according to the present embodiment, the distal end portion of the coil sheath 31 is lubricated with a reduced diameter to attach the ring 42, and the distal end portion of the coil sheath 31 is placed in the distal end support frame 41 for supporting the treatment portion. And the opening 41e of the tip support frame 41 is closed so as to reduce the opening diameter by using a pair of half rings 43, so that the coil sheath 31 can be removed as shown in FIG. The distal end support frame 41 that supports the treatment portion 33 can be connected to be rotatable in the Z direction in the figure.

DESCRIPTION OF SYMBOLS 1 Endoscope system, 1a Endoscope channel, 8 Silver raw material, 10 Operation part,
DESCRIPTION OF SYMBOLS 11 Insertion part, 12 Treatment tool introduction part, 30 Endoscope treatment tool, 32 Operation wire,
33 treatment section, 34 operation section, 34a operation section main body, 34b slider,
35 rotation shaft, 36a rod, 37a shaft, 38a link, 38c metal fitting,
40c Projection part, 41 Tip support frame, 41a Support frame body, 41b Arm part, 41c Locking part, 42 ring, 43 Half ring

Claims (4)

A flexible long cylindrical coil sheath with metal wound tightly;
An operation wire disposed in the coil sheath so as to be movable back and forth in the longitudinal direction;
An operation portion attached to a proximal end side of the operation wire and the coil sheath, and for operating the operation wire to advance and retract within the coil sheath;
A treatment section for treating living tissue;
A tip support means having a pair of arms for supporting the treatment portion and having an opening for inserting the tip side of the operation wire, and connecting the tip of the operation wire to the treatment portion;
An endoscopic treatment instrument comprising:
The coil sheath whose tip is ground so that the tip side is reduced in diameter;
A ring that is welded to the tip of the coil sheath and has a larger outer diameter than the diameter reduced by the slip-off preventing member;
A slip prevention member welded so as to reduce the diameter of the opening in a state in which the tip of the coil sheath welded to the tip is inserted into the opening;
An endoscopic treatment instrument comprising:   The treatment instrument for an endoscope according to claim 1, wherein an outer peripheral surface of the ring in contact with the inner wall of the opening of the tip support means is formed in an arc shape in cross section.   The treatment instrument for an endoscope according to claim 1 or 2, wherein a slip-off preventing member surface in contact with the outer periphery of the coil sheath is formed in an arc shape in cross section. The endoscopic treatment tool according to any one of claims 1 to 3, wherein at least a distal end portion of the coil sheath is coated with an alloy.

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