JP2019047959A - Distal end treatment tool for high-frequency treatment instrument and medical high-frequency treatment instrument - Google Patents

Abstract

To provide a distal end treatment tool for a high-frequency treatment instrument configured to suppress interference with a distal end of an endoscope.SOLUTION: A distal end treatment tool 100 for a high-frequency treatment instrument provided at a distal end of a medical high-frequency treatment instrument 200, the distal end treatment tool 100 for the high-frequency treatment instrument used with it inserted into a forceps hole of an endoscope and cutting a biological tissue, includes a distal end treatment unit 10 comprised of a pair of opening/closing portions 10a and 10b respectively including line-shaped electrodes 52 formed thereon, journaled by a common rotary shaft so as to be mutually openably/closably formed, and shearing or clamping the biological tissue to perform high-frequency cutting. The shape of a distal end-side portion of the distal end treatment unit 10 when viewing it in the axial direction of the rotary shaft, with the pair of opening/closing portions 10a and 10b closed, is tapered from the proximal end to the distal end and then narrowed.SELECTED DRAWING: Figure 2

Description

  The present invention relates to a distal end treatment tool for a high frequency treatment tool and a high frequency treatment tool for medical use.

  A high-frequency treatment tool which is used by being inserted into a forceps hole of an endoscope is known as a medical instrument for performing a treatment (including a treatment for excising a lesion site) for incising a living tissue in a body cavity.

  For example, Patent Document 1 describes a high-frequency treatment tool including a distal end treatment tool (a high-frequency treatment tool distal-end treatment tool) including a pair of openable / closable opening / closing portions at the distal end.

International Publication No. 2011-043340 brochure

  However, according to the study of the inventor of the present application, in the technique of Patent Document 1, when performing a treatment by causing the distal end treatment tool to protrude from the tip of the endoscope and opening the pair of opening and closing parts, For example, the pair of opening / closing portions easily interfere with the tip of the hood).

  The present invention has been made in view of the above problems, and it is an object of the present invention to provide a high-frequency treatment tool for high-frequency treatment tool capable of suppressing interference with the tip of an endoscope, and a high-frequency treatment tool for medical use. It is provided.

The present invention is a tip treatment tool for a high frequency treatment tool which is provided at the tip of a high frequency treatment tool for medical use and is inserted into a forceps hole of an endoscope and used to incise a living tissue,
Each of the line-shaped electrodes is formed, supported by a common rotation axis so as to be able to open and close each other, and a tip constituted by a pair of open-close parts that shear or pinch the living tissue to perform high frequency ablation. Equipped with a treatment unit,
In the state where the pair of opening and closing parts are closed, the shape of the distal end side portion of the distal end treatment part when viewed in the axial direction of the rotation shaft becomes wider after becoming wider from the distal end to the proximal end It is an object of the present invention to provide a distal end treatment tool for a high frequency treatment tool, which is shaped as follows.

  The present invention also includes a medical treatment high frequency treatment having the distal end treatment tool for a high frequency treatment tool of the present invention at the distal end, and an operation unit for performing the opening and closing operation of the pair of opening and closing units on the base end side. Provide the

  According to the present invention, it is possible to suppress the interference between the pair of opening and closing parts of the distal end treatment tool for high frequency treatment tool and the tip of the endoscope.

It is a schematic diagram which shows the whole structure of the medical high frequency treatment tool which concerns on 1st Embodiment. It is a side view with which the medical high frequency treatment tool which concerns on 1st Embodiment equips a front-end | tip part with the front-end | tip treatment tool for high frequency treatment tools, and shows the state which a pair of opening / closing parts closed. It is a side view with which the medical high frequency treatment tool which concerns on 1st Embodiment equips a front-end | tip part with the front-end | tip treatment tool for high frequency treatment tools, and shows the state which a pair of opening-and-closing parts opened. It is a top view with which the medical high frequency treatment tool concerning a 1st embodiment is equipped with a tip part in the tip part, and is a top view showing a state where a pair of opening and closing parts closed. It is a cutting end view along the AA line of FIG. FIG. 6 is a side view showing a state in which the distal end treatment tool for a high frequency treatment tool provided at the distal end portion of the medical high frequency treatment tool according to the first embodiment protrudes from a hood provided at the tip of the endoscope. It is a side view with which the medical high frequency treatment tool which concerns on 2nd Embodiment is equipped with a front-end | tip part in the front-end | tip part, and the state where a pair of opening-and-closing parts closed. It is a side view with which the medical high frequency treatment tool which concerns on 2nd Embodiment equips a front-end | tip part with the front-end | tip treatment tool for high frequency treatment tools, and shows the state which a pair of opening-and-closing parts opened. It is a perspective view of the tip part of one opening-and-closing part of the tip treatment implement for high frequency treatment instruments concerning a 2nd embodiment.

Hereinafter, embodiments of the present invention will be described using the drawings. In all the drawings, the same components are denoted by the same reference numerals, and the description thereof will be omitted as appropriate.
The various components of the medical high-frequency treatment tool according to the present embodiment do not have to be individually independent, but a plurality of components are formed as a single member, a plurality of one component is plural. Allow one component to be part of another component, or that part of one component and part of another component overlap, etc. .

First Embodiment
First, the first embodiment will be described using FIGS. 1 to 6.
In the side views shown in FIG. 2 and FIG. 3, the proximal end portion of the illustrated range of the sheath 70 shows a side cross section along the center line.
In the following description, the direction of the distal end of the distal treatment section 10 means the axial center 61a of the rotation shaft (shaft member 61) to the distal end of the distal treatment section 10 (opening / closing units 10a and 10b) (left end of the distal treatment section 10 in FIG. 2) And the proximal direction of the distal treatment section 10 is the opposite direction. Therefore, the front proximal direction is the left-right direction in FIG.

As shown in any of FIG. 1 to FIG. 4, the distal end treatment tool 100 for a high frequency treatment tool according to the present embodiment is a medical high frequency treatment tool 200 (hereinafter sometimes referred to simply as the high frequency treatment tool 200). It is provided at the distal end, and is used by being inserted into the forceps hole (not shown) of the endoscope 300 (FIG. 7 shows a portion on the distal end side of the hood 310 of the distal end of the endoscope 300). This is a tip treatment instrument 100 for high frequency treatment instrument which incises a tissue (not shown).
As the distal end treatment tool 100 for a high frequency treatment tool according to the present embodiment, a biopsy forceps having a pair of cup-shaped opening and closing parts is excluded.
The high-frequency treatment tool tip treatment tool 100 includes a tip treatment unit 10 configured by a pair of opening / closing units 10a and 10b. Line-like (linear) electrodes 52 are formed on the pair of opening and closing parts 10a and 10b, respectively. The line-shaped electrode 52 is not an annular or U-shaped electrode as seen in a biopsy forceps having a pair of cup-shaped opening and closing parts. Note that the electrode 52 may have a height difference or may be meandering for each portion.
The pair of opening and closing parts 10a and 10b are pivotally supported on a common rotation shaft (the shaft member 61 shown in FIGS. 2 and 3) and can be opened and closed mutually, and shear or pinch living tissue to perform high frequency ablation .
The pair of opening and closing parts 10a and 10b has a plate-like or rod-like shape, not a cup-like shape.
When the pair of opening / closing portions 10a and 10b are closed, the shape of the tip end portion of the tip treatment section 10 when viewed in the axial direction of the rotation shaft (direction orthogonal to the sheet of FIG. 2) is the tip After becoming wider toward the proximal end, the shape becomes narrower. The term "wide or narrow" as used herein means wide or narrow in the opening direction (vertical direction in FIG. 2) of the pair of opening / closing portions 10a and 10b.
In other words, in the state in which the pair of opening / closing portions 10a and 10b are closed, the portion of the tip end side of the distal end treatment portion 10 when viewed in the axial direction of the rotation axis (direction orthogonal to the page of FIG. 2) The shape is a shape that narrows after becoming wide from the proximal end to the distal end.
The distal end treatment unit 10 is a portion positioned on the distal end side of the rotation shaft (shaft member 61) in the pair of opening and closing portions 10a and 10b, and in the case of the present embodiment, holding in the pair of opening and closing portions 10a and 10b The portion of the frame 80 protruding from the bracket 82 to the tip side is the distal end treatment section 10.

  Further, the medical high-frequency treatment tool 200 according to the present embodiment has the distal end portion 100 for the high-frequency treatment tool according to the present embodiment at the distal end, and the proximal end has the pair of opening / closing portions 10a and 10b. It has a hand operation unit (operation unit) 90 for performing an opening / closing operation.

According to the present embodiment, with the pair of opening / closing parts 10a and 10b closed, the shape of the distal end side of the distal end treatment part 10 when viewed in the axial direction of the rotation shaft is directed from the distal end to the proximal end After becoming wide and narrow, as shown in FIG. 6, the distal treatment section 10 is protruded from the tip of the endoscope 300 to open the pair of opening / closing sections 10a and 10b. When performing the medical treatment, the interference of the pair of opening and closing parts 10a and 10b with the tip of the endoscope 300 (for example, the tip of the hood 310) can be suppressed.
In addition, since the distal end treatment unit 10 contacts the peripheral wall of the forceps hole (not shown) of the endoscope 300 substantially in point contact, the operation for advancing the distal end treatment tool 100 for high frequency treatment instrument in the forceps hole is smoothed. Can.
In addition, the pair of open / close units 10a, 10b may be rotated in an open state, and in this case, living tissue located behind the pair of open / close units 10a, 10b and the pair of open / close units 10a, 10b. And interference between

In the case of this embodiment, the high-frequency treatment tool 200 for medical use is a forceps, and each of the pair of opening and closing parts 10a and 10b is a thin plate-like shearing flange, and the pair of opening and closing parts 10a and 10b are pivotally supported. The axial direction of the shaft member 61 extends in the thickness direction of the pair of opening and closing parts 10a and 10b.
Each of the pair of opening and closing parts 10a and 10b has a blade 50 for shearing a living tissue.
More specifically, each of the pair of opening and closing parts 10a and 10b is formed on the base end side of each of the pair of opening and closing parts 10a and 10b and is supported by the rotation shaft at the rotation shaft. A tip claw 40 formed at the tip of each of the opening and closing portions 10a and 10b, and a blade formed between the tip claw 40 and the base end piece 20 in each of the pair of opening and closing portions 10a and 10b And 50. The above-described line-like electrode 52 is formed on the blade portion 50.

  As shown in FIG. 1, the high-frequency treatment tool 200 includes a long operation wire 68, a high-frequency treatment tool tip treatment tool 100 provided at the tip of the operation wire 68, and flexibility in which the operation wire 68 is accommodated. And a proximal operating portion 90 provided on the proximal end side of the sheath 70 and to which the proximal end of the operation wire 68 is connected.

  The sheath 70 is an elongated and tubular member that accommodates the operation wire 68. In the case of this embodiment, the sheath 70 is a metal coil 71 (FIGS. 2 and 3) manufactured by closely winding a conductive wire such as a stainless steel wire. An insulating film 72 is provided in close contact with the outer surface of the sheath 70. However, as the sheath 70, an insulating tubular member (tube) may be used instead of the metal coil 71.

In the hand operation unit 90 shown in FIG. 1, the shaft 95 through which the operation wire 68 is inserted, the finger ring 92 provided at the base end of the shaft 95, and the base end of the operation wire 68 are connected. And a slider 93 moving forward and backward with respect to the shaft 95. The operation wire 68 is slidably inserted into the shaft 95. The user inserts, for example, a thumb into the finger ring 92 and sandwiches the slider 93 between the other two fingers to drive back and forth along the longitudinal direction of the shaft 95. Thereby, the operation wire 68 is advanced or retracted relative to the hand operation unit 90. The proximal end of the sheath 70 is fixed to the hand operation portion 90, and the operation wire 68 is inserted into the sheath 70 so as to be able to move back and forth. Move forward or backward. As a result, as described later, the advancing and retracting portion 67 (FIGS. 2 and 3) of the high-frequency treatment instrument tip treatment tool 100 is driven to move forward and backward to open and close the pair of opening and closing units 10a and 10b.
The axial direction of the rotation axis of the pair of opening and closing parts 10a and 10b is a direction orthogonal to the plate surface of the pair of opening and closing parts 10a and 10b, and when the pair of opening and closing parts 10a and 10b opens and closes, the pair of Portions of the facing surfaces 16 (see FIG. 5) of the opening and closing portions 10a and 10b slide relative to each other.

  As shown in FIG. 1, the hand operation unit 90 includes a power feeding unit 91. The power supply unit 91 is a terminal for applying a high frequency current to the pair of opening / closing units 10a and 10b, and a high frequency power supply (not shown) is connected via a power supply cable. The pair of opening and closing parts 10a and 10b, the link pieces 65 and 66, and the advancing and retracting part 67 which constitute the high-frequency treatment tool tip treatment tool 100 are all made of a conductive metal material. The operation wire 68 is also made of a conductive metal material. For this reason, the high frequency current input to the power supply unit 91 is applied to the pair of switching units 10a and 10b.

As shown in FIGS. 2 and 3, the high-frequency treatment tool tip treatment tool 100 has a pair of plate-like opening and closing parts 10 a and 10 b and a shaft pivotally supporting the pair of opening and closing parts 10 a and 10 b in an openable and closable manner. A member 61, two link pieces 65 and 66, an advancing and retracting portion 67, and a holding frame 80 are provided.
The pair of opening and closing parts 10 a and 10 b is opened and closed by pushing and pulling the operation wire 68. The operation wire 68 is made of a conductive metal material such as stainless steel.

The advancing and retracting portion 67 is integrally connected to the tip of the operation wire 68. Two link pieces 65 and 66 are rotatably connected to the advancing and retracting portion 67 by a shaft member 64. Furthermore, the base end piece 20 of one opening and closing portion 10a is rotatably connected to the link piece 65 by the shaft member 63, and the base end piece 20 of the other opening and closing portion 10b is rotated by the shaft member 62 to the link piece 66. It is linked in a movable manner.
The axial direction of each shaft member 62, 63, 64 is a direction parallel to the axial direction of the shaft member 61.
The pair of opening / closing parts 10a and 10b and the link pieces 65 and 66 relatively rotate in the plane shown in FIGS. 2 and 3 (in the plane orthogonal to the axial direction of the shaft member 61).
A rhombus four-bar link is configured by the base end pieces 20 of the pair of opening and closing parts 10 a and 10 b and the link pieces 65 and 66.
The shaft members 62 and 63 are located on the tip side of the shaft member 64, and the shaft member 61 is located on the tip side of the shaft members 62 and 63.

The holding frame 80 is fixed to the tip of the sheath 70.
The holding frame 80 includes a proximal end 81 fixed to the distal end of the sheath 70 and a pair of brackets 82 projecting from the proximal end 81 toward the distal end.
The bracket 82 is formed, for example, in a plate shape.
The pair of opening / closing portions 10 a and 10 b is pivotally supported by the shaft member 61 with respect to the tip end portions of the pair of brackets 82.
In the gap between the pair of brackets 82, the proximal end piece 20 of the pair of opening and closing parts 10a and 10b and the link pieces 65 and 66 are rotatable, and project from the sheath 70 to the distal end side in the advancing and retracting part 67 It is possible to move forward and backward.

  As described above, the high-frequency treatment tool tip treatment tool 100 holds the base end portions of the pair of opening / closing portions 10a and 10b from both sides in the axial direction of the rotation shaft (shaft member 61) The pair of brackets 82 are provided.

  As shown in FIG. 2, when the operation wire 68 and the advancing and retracting part 67 are pulled to the proximal end side (right side in FIG. 2), the pair of opening and closing parts 10 a and 10 b is closed. Conversely, as shown in FIG. 3, when the operation wire 68 and the advancing and retracting portion 67 are pushed out to the tip end side (left in FIG. 3), the pair of opening and closing portions 10a and 10b are opened.

  Each of the pair of opening and closing portions 10 a and 10 b has a substantially L shape (i.e., a wedge shape) which is shallowly bent in the rotation plane in the vicinity of the shaft member 61. The proximal end piece 20 is a portion on the proximal side of the shaft member 61 in each of the pair of opening / closing parts 10 a and 10 b. On the other hand, in each of the pair of opening and closing parts 10a and 10b, a portion on the tip end side of the shaft member 61 is referred to as a tip piece 30.

  The shapes of the pair of opening and closing parts 10a and 10b may be identical to each other or may be different from each other. In the case of the present embodiment, the pair of opening and closing parts 10a and 10b have the same shape.

A tip claw portion 40 is formed at the tip of the tip end piece 30 of each of the opening / closing portions 10a and 10b. The tip claws 40 project in the closing direction. The closing direction is a direction in which the pair of opening and closing portions 10a and 10b close, that is, a direction from one opening and closing portion 10a to the other opening and closing portion 10b and a direction from the other opening and closing portion 10b to the one opening and closing portion 10a. Further, the direction in which the pair of opening and closing parts 10a and 10b open is referred to as the opening direction.
The tip claw portion 40 is a protrusion that bites into a living tissue.
A blade 50 is formed along an end edge on the closing direction side of a portion of the tip piece 30 on the proximal side of the tip claw portion 40.
In a state where the living tissue is held so as to be held by the tip claws 40 of the pair of opening and closing parts 10a and 10b to prevent dropping of the living tissue, the living tissue is incised by the blade parts 50 of the pair of opening and closing parts 10a and 10b It is possible to

An insulating film 12 (FIGS. 2 and 3) is formed on the surface of each of the pair of opening / closing parts 10a and 10b. Insulating film 12 is formed on at least the entire surface of tip piece 30 except for the area where electrode 52 is formed.
Insulating film 12 can be formed, for example, by coating an insulating material such as a fluorine resin on the surfaces of opening / closing portions 10a and 10b.
The film thickness of the insulating film 12 may be locally thicker than the film thickness of the other part in the widest part of the distal end treatment part 10. By doing this, even when the distal end treatment portion 10 makes a point contact with the peripheral wall of the forceps hole (not shown) of the endoscope 300 and moves back and forth, insulation in the widest portion of the distal end treatment portion 10 Peeling of the metallic coating 12 can be suppressed, and the exposure of the metal base in the portion can be suppressed.
The electrode 52 is a linear portion exposed from the insulating coating 12 at the blade portion 50. The pair of switch units 10a and 10b is applied with a high frequency voltage of the same phase from the power supply unit 91 to become a monopolar high frequency electrode. The biological tissue is cauterized and cut out by applying a high frequency current to the pair of opening and closing parts 10a and 10b in a state where the living tissue is gripped by the pair of opening and closing parts 10a and 10b. Note that, instead of the present embodiment, it is also possible to use a bipolar high-frequency treatment instrument 200 in which one of the pair of opening and closing parts 10a and 10b is an active electrode and the other is a return electrode.

The shape of the blade portion 50 is not particularly limited, but in the case of the present embodiment, the blade portion 50 includes a high step portion 54 and a notch-shaped low step portion 55 recessed toward the opening direction side relative to the high step portion 54. And are being formed.
The electrode 52 is continuously formed, for example, across the proximal end side edge of the distal end claw portion 40, the low step 55, and the electrode proximal end 52a located at the proximal end of the high step 54. There is.

  In the case of the present embodiment, “the distal end side portion of the distal end treatment portion 10”, that is, “the shape when viewed in the axial direction of the rotation shaft with the pair of open / close portions 10a and 10b closed, The portion having a shape that narrows after becoming wider toward the end is a portion distal to the proximal end of the formation region of the electrode 52 (electrode proximal position 52a).

  More specifically, in the case of the present embodiment, the “tip side portion of the tip treatment portion 10” is a portion on the tip side with respect to the intermediate position C1 (FIG. 2) in the front proximal direction of the tip treatment portion 10. In other words, after the distal end portion of the distal treatment section 10 is divided in the distal proximal direction with the pair of open / close portions 10a and 10b closed, the distal end becomes wider from the distal end to the proximal end The shape is

More specifically, “the distal end portion of the distal treatment section 10” gradually widens from the distal end to the proximal end in both the upper and lower directions in FIG. 2 and then gradually narrows. It is a shape.
More specifically, the entire distal treatment section 10 has a shape that gradually widens from the distal end to the proximal end in both the upper and lower directions in FIG. 2 and then gradually narrows. That is, in the distal end treatment unit 10, the portion closer to the base end than the widest portion in the vertical direction in FIG. 2 is gradually monotonously narrowed.

A stopper portion 11 is formed on at least one of the pair of opening and closing portions 10a and 10b. The closing operation of the pair of opening and closing parts 10a and 10b is regulated by the stopper part 11 contacting the blade part 50 of the other opening and closing part (the opening and closing part 10a or the opening and closing part 10b).
In the case of this embodiment, the stopper portion 11 is formed in each of the pair of opening and closing portions 10a and 10b, and the stopper portion 11 of the opening and closing portion 10a abuts on the blade portion 50 of the opening and closing portion 10b and the stopper of the opening and closing portion 10b When the portion 11 abuts on the blade portion 50 of the opening and closing portion 10a, the closing operation of the pair of opening and closing portions 10a and 10b is regulated.
In the stopper portion 11, a portion facing the other opening / closing portion (opening / closing portion 10a or 10b) side is a flat surface 11a.

As shown in FIGS. 2 to 4, a stepped portion 23 is formed on the outer side surface of the base end piece 20. The proximal end portion of the proximal end piece 20 relative to the stepped portion 23 is thinner than the distal end portion of the stepped portion 23.
As shown in FIG. 4, in the base end piece 20, the difference in thickness between the portion on the proximal end side and the portion on the distal end side of the step portion 23 is set to be slightly larger than the thickness of the link pieces 65 and 66 Or set equal to the thickness of the link pieces 65, 66.

As shown in FIG. 2, with the pair of opening / closing parts 10a and 10b closed, in the direction perpendicular to both the front proximal direction and the axial direction (that is, in the vertical direction in FIG. 2) The dimensions of the proximal end 19 of the bracket are smaller than the dimensions of the bracket 82. That is, the dimension W1 shown in FIG. 2 is smaller than the dimension W2.
With such a configuration, when performing treatment by causing the distal end treatment unit 10 to project from the distal end of the endoscope 300 and opening the pair of open / close units 10a and 10b, the pair of open / close units 10a with respect to the distal end of the endoscope 300, 10b interference can be further suppressed.
Similarly, in the case where the pair of opening and closing parts 10a and 10b are rotated in an open state, interference between the pair of opening and closing parts 10a and 10b and the living tissue located behind the pair of opening and closing parts 10a and 10b Can be further suppressed.

As shown in FIG. 4, the pair of brackets 82 of the holding frame 80 is provided on both sides in the axial direction of the rotation shaft (shaft member 61) of the pair of opening and closing portions 10 a and 10 b of the base end piece 20 of the pair of opening and closing portions 10 a and 10 b. And is supported by the rotating shaft. The pair of brackets 82 sandwiches and pivotally supports the proximal end piece 20 at the distal end portion of the bracket 82.
At the tip of each of the pair of brackets 82, an outer surface 82b which is a back surface to the opposing surface 82a of each of the pair of brackets 82 is formed flat. Moreover, the distance between the outer surfaces 82 b of the distal end of each of the pair of brackets 82 is smaller than the distance between the outer surfaces of the proximal end of the bracket 82. That is, the front end portion of the bracket 82 has a shape in which the outer surface side is scraped off and becomes flat.
For this reason, interference with the bracket 82 and the surrounding wall of a biological tissue or a forceps hole can be suppressed. Moreover, the effect that the paint with respect to the bracket 82 is easy is also acquired.

Here, as shown in FIG. 5, the boundary portion 15 between the edge portion 13 on the opening direction side of the pair of opening / closing portions 10a and 10b and the outer surface 14 is chamfered.
Thereby, since the distal end treatment unit 10 can slide more smoothly on the peripheral wall of the forceps hole (not shown) of the endoscope 300, the operation for advancing the high frequency treatment instrument distal end treatment tool 100 in the forceps hole is smooth. can do.
The boundary portion 15 preferably has an R-chamfered shape.

Further, the boundary portion 17 between the edge portion 13 on the opening direction side of the pair of opening and closing portions 10a and 10b and the facing surface 16 is also formed into a chamfered shape.
Thereby, since the distal end treatment unit 10 can slide more smoothly on the peripheral wall of the forceps hole (not shown) of the endoscope 300, the operation for advancing the high frequency treatment instrument distal end treatment tool 100 in the forceps hole is smooth. can do.
It is preferable that the boundary portion 17 also have an R-chamfered shape.

  According to the first embodiment as described above, the height based on the virtual straight line L1 is the largest of the formation regions (electrode formation regions 53) of the electrodes 52 in the blade unit 50 than the height of the tip claws 40. Since the height of the high position is lower, the operation of pushing back the living tissue by the blade unit 50 when the pair of opening / closing units 10a and 10b is closed is suppressed. For this reason, when closing the pair of opening and closing parts 10a and 10b, the tip claw part 40 can be immediately bitten into the living tissue, and the living tissue can be more reliably grasped by the pair of opening and closing parts 10a and 10b is there.

Second Embodiment
Next, a second embodiment will be described using FIGS. 7 to 9.
The high-frequency treatment instrument 200 and the high-frequency treatment instrument distal-end treatment instrument 100 according to the present embodiment are different from the high-frequency treatment instrument 200 and the high-frequency treatment instrument distal-end treatment instrument 100 according to the first embodiment in the points described below. In other respects, the configuration is the same as that of the high frequency treatment device 200 and the high end treatment device 100 according to the first embodiment described above.

In the above-described first embodiment, an example in which each of the pair of opening and closing parts 10a and 10b is a thin plate-like shearing ridge portion has been described, but in the case of this embodiment, the pair of opening and closing parts 10a and 10b is formed in a bar shape respectively And are provided with facing surfaces 56, 57 facing each other.
When the pair of opening and closing parts 10a and 10b are closed, the opposing surface 56 and the opposing surface 57 overlap each other in the opening and closing direction of the pair of opening and closing parts 10a and 10b.
The pair of opening / closing parts 10 a and 10 b is configured to hold the living tissue by the facing surfaces 56 and 57.

  As shown in FIG. 9, for example, an electrode 52 extending in the proximal direction is formed at the central portion in the width direction of the opening / closing portion 10a. Similarly, although not shown, an electrode 52 extending in the proximal direction is formed at a central portion in the width direction of the opening and closing portion 10b.

For example, among the opening and closing portion 10a and the opening and closing portion 10b, the end claw portion 40 is formed at the end of the opening and closing portion 10a, and the end claw 40 is not formed at the end of the opening and closing portion 10b.
The opening and closing portion 10 b is formed shorter than the opening and closing portion 10 a because it does not have the end claw portion 40. As shown in FIG. 7, in a state where the pair of opening and closing parts 10a and 10b are closed, the surface on the base end side of the end hook 40 of the opening and closing part 10a abuts or approaches the end face of the opening and closing part 10b It has become.

Also in the case of the present embodiment, the distal end side of the distal end treatment unit 10 when viewed in the axial direction of the rotation shaft (direction orthogonal to the sheet of FIG. 7) with the pair of opening / closing units 10 a and 10 b closed. The shape of the part of the shape is a shape that narrows after becoming wider from the distal end to the proximal end.
Further, also in the case of the present embodiment, the distal end side portion of the distal end treatment section 10 is the distal end side portion rather than the proximal end of the formation region of the electrode 52.
Also in the case of the present embodiment, the distal end side portion of the distal end treatment portion 10 is a portion on the distal end side with respect to the intermediate position in the front proximal direction of the distal end treatment portion 10.

  The same effect as that of the first embodiment can be obtained also by the present embodiment.

As mentioned above, although each embodiment was described with reference to drawings, these are illustrations of the present invention and can also adopt various composition except the above.
Further, the above-described embodiments can be combined as appropriate without departing from the spirit of the present invention.

The present embodiment includes the following technical ideas.
(1) A distal end treatment tool for a high frequency treatment tool, which is provided at the tip of a high frequency treatment tool for medical use and is inserted into a forceps hole of an endoscope and used to incise a living tissue,
Each of the line-shaped electrodes is formed, supported by a common rotation axis so as to be able to open and close each other, and a tip constituted by a pair of open-close parts that shear or pinch the living tissue to perform high frequency ablation. Equipped with a treatment unit,
In the state where the pair of opening and closing parts are closed, the shape of the distal end side portion of the distal end treatment part when viewed in the axial direction of the rotation shaft becomes wider after becoming wider from the distal end to the proximal end The tip treatment tool for high frequency treatment tool which is shaped as follows.
(2) The tip treatment tool for a high frequency treatment tool according to (1), wherein the tip end side portion of the tip treatment portion is a tip end side of a proximal end of a formation region of the electrode.
(3) The tip for high frequency treatment tool according to (1) or (2), wherein the tip side portion of the tip treatment portion is a portion on the tip side with respect to an intermediate position in the tip proximal direction of the tip treatment portion. Treatment tool.
(4) A pair of brackets supporting the proximal end portions of the pair of opening and closing parts from both sides in the axial direction of the rotary shaft and axially supporting the rotary shaft,
In the state where the pair of opening and closing parts are closed, the dimension of the proximal end of the distal end treatment part is smaller than the dimension of the bracket in the direction orthogonal to both the proximal direction and the axial direction The tip treatment tool for a high frequency treatment tool according to any one of 1) to 3).
(5) The tip end treatment tool for a high frequency treatment tool according to any one of (1) to (4), wherein the boundary between the edge in the opening direction of the pair of opening and closing parts and the outer surface is chamfered. .
(6) The base end portion of the pair of opening and closing portions is provided with a pair of brackets which sandwich the base end from both sides in the axial direction of the rotating shaft and support the rotating shaft at the rotating shaft.
The pair of brackets sandwich and pivotally support the pair of opening and closing portions at the tip end of the bracket,
At the tip of each of the pair of brackets, the outer surface which is the back surface to the opposing surface of each of the pair of brackets is formed flat,
and,
The tip for the high frequency treatment tool according to any one of (1) to (5), wherein the distance between the outer surfaces of the tip of each of the pair of brackets is smaller than the distance between the outer surfaces of the proximal end of the bracket Treatment tool.
(7) A distal end portion of the distal end portion of the high frequency treatment instrument according to any one of (1) to (6) and the proximal end side for opening and closing the pair of opening and closing portions Medical high-frequency treatment tool having an operation unit.

DESCRIPTION OF SYMBOLS 10 tip treatment part 10a, 10b opening / closing part 11 stopper part 11a flat surface 12 insulating film 13 edge part 14 outer surface 15 boundary part 16 opposing surface 17 boundary part 19 base part 20 base end piece 23 step part 30 tip part 40 tip claw Part 50 Blade part 52 Electrode 52a Electrode base end position 54 High step part 55 Low step part 56, 57 Opposite surfaces 61, 62, 63, 64 Shaft member 61a Axial center 65, 66 Link piece 67 Advancement / retraction part 68 Operation wire 70 Sheath 71 Coil 72 Insulating film 80 Holding frame 81 Base end 82 Bracket 82a Opposing surface 82b Outer surface 90 Hand operation section (operation section)
91 Power feeding portion 92 Finger ring 93 Slider 94 Rotation operating portion 95 Shaft portion 100 Tip treatment instrument for high frequency treatment instrument 200 High frequency treatment instrument 300 for medical use Endoscope 310 Hood

Claims (7)

A distal end treatment tool for a high frequency treatment tool, which is provided at the tip of a high frequency treatment tool for medical use and is inserted into a forceps hole of an endoscope and used to incise a living tissue,
Each of the line-shaped electrodes is formed, supported by a common rotation axis so as to be able to open and close each other, and a tip constituted by a pair of open-close parts that shear or pinch the living tissue to perform high frequency ablation. Equipped with a treatment unit,
In the state where the pair of opening and closing parts are closed, the shape of the distal end side portion of the distal end treatment part when viewed in the axial direction of the rotation shaft becomes wider after becoming wider from the distal end to the proximal end The tip treatment tool for high frequency treatment tool which is shaped as follows.   The tip treatment tool for a high frequency treatment tool according to claim 1, wherein the tip end side portion of the tip treatment portion is a tip end side of a proximal end of a formation region of the electrode.   The tip treatment tool for a high frequency treatment tool according to claim 1 or 2, wherein the tip end side portion of the tip treatment portion is a tip end side of an intermediate position in the tip proximal direction of the tip treatment portion. The base end portion of the pair of opening and closing portions is provided with a pair of brackets which are supported from both sides in the axial direction of the rotation shaft and supported by the rotation shaft,
The dimension of the proximal end portion of the distal end treatment portion is smaller than the dimension of the bracket in the direction orthogonal to both the distal proximal direction and the axial direction with the pair of opening / closing portions closed. The tip treatment tool for a high frequency treatment tool according to any one of Items 1 to 3.   The tip end treatment tool for a high frequency treatment tool according to any one of claims 1 to 4, wherein a boundary between the edge in the opening direction of the pair of opening and closing parts and the outer surface is chamfered. The base end portion of the pair of opening and closing portions is provided with a pair of brackets which are supported from both sides in the axial direction of the rotation shaft and supported by the rotation shaft,
The pair of brackets sandwich and pivotally support the pair of opening and closing portions at the tip end of the bracket,
At the tip of each of the pair of brackets, the outer surface which is the back surface to the opposing surface of each of the pair of brackets is formed flat,
and,
The tip treatment tool for a high frequency treatment tool according to any one of claims 1 to 5, wherein a distance between outer surfaces of tip end portions of the pair of brackets is smaller than a distance between outer surfaces of proximal ends of the brackets. .   A medical device having the distal end treatment tool for a high frequency treatment tool according to any one of claims 1 to 6 at the distal end, and an operation unit for performing the opening and closing operation of the pair of opening and closing units on the base end side. High-frequency treatment tool.

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