JP2020185035A - Endoscopic electrocautery incision scissors - Google Patents

Abstract

To provide endoscopic electrocautery incision scissors that can realize a hemostasis incision for achieving antinomy between the sufficient provision of heat transfer quantity of the Joule heat from a cutting part to a boundary part between a lesion region and a normal tissue and the suppression of the heat transfer quantity to the normal tissue side, even if an incision time is taken for a long time in comparison with before.SOLUTION: Endoscopic electrocautery incision scissors include: a sheath 11, an operation wire 12, an operation part 13, treatment part support means 14 having a cylindrical part 14a and a pair of arm parts 14b; and a scissors part 16 where tip side portions 17c, 18c of respective scissor pieces 17, 18 are opened and closed, only the cutting part of the tip side portions 17c, 18c is not provided with an insulated film and is provided to become non-contact with each other, and a required voltage is applied to make an incision in the affected area of the living tissue. The respective scissor pieces 17, 18 have thread parts 25, 26 provided as the cutting part; and arch-shaped support frames 27, 28 for supporting a proximal end (a) and a tip end b of the thread parts 25, 26, and being separated from the thread parts 25, 26 in the place between the proximal end (a) and the tip end b.SELECTED DRAWING: Figure 3

Description

The present invention relates to an electric scissors incision scissors for an endoscope in which a pair of scissors sandwiches a living tissue in a body cavity and a required current is applied to cauterize the living tissue to stop bleeding.

Conventionally, endoscopy as a treatment tool for an endoscope used together with an endoscope as a medical instrument for performing treatments such as excision of a lesion site in the body cavity or incision of a living tissue to stop bleeding. Electrocautery incision shears for endoscopes (high-frequency treatment tools for endoscopes, ultrasonic treatment tools for endoscopes, microwave treatment tools for endoscopes, etc.) are known.

The endoscopic electrocautery incision scissors has, for example, a treatment portion having a pair of scissors pieces having a conductive blade portion and an insulating coating other than the blade portion at the tip position inserted into the body cavity of the living body. After injecting hyaluronic acid or the like under the affected area in advance to raise the lesion site from the normal tissue, the treated area is inserted into the endoscopic treatment tool guide duct freely. Furthermore, by projecting from the opening at the tip of the endoscope and inserting it into the body cavity of the living body and remotely operating the treatment part on the proximal end side, it is necessary to sandwich the boundary site between the lesion site and normal tissue with a pair of scissors pieces. (For example, high-frequency voltage, low-voltage incision waveform voltage, microwave, ultrasonic wave, etc.) is applied to incision while stopping bleeding to remove the lesion site by cauterization.

JP-A-2016-87450

The conventional electrocautery incision scissors for endoscopes are provided with a pair of scissors pieces whose treatment part can open and close the part beyond the rotation shaft, and each scissors piece part is provided with a conductive blade part and a blade. Approximately the entire peripheral surface excluding the portion is covered with an insulating film, and a high-frequency current is applied to the blade portion to cauterize the biological tissue in the body cavity to stop bleeding and make an incision.

When the blades are energized in a bipolar type, the mucosa can be energized even after the pair of blades pass each other, and Joule heat is transferred to the mucosal tissue to be incised for a long time. A smooth incision can be made because sufficient time is required for evaporation and solidification of the blade. However, in the case of the monopolar type, there is a problem that incision cannot be performed because the power is not supplied after the pair of blades pass each other.

Furthermore, in both the bipolar type and the monopolar type, the pair of scissors pieces close at the time of incision and the heat transfer is blocked from the boundary site between the lesion site and the normal tissue. Therefore, the longer the incision time, the more the blade portion. The Joule heat transferred from the normal tissue to the normal normal tissue raises the temperature of the normal tissue. To enable a smooth incision, lengthen the time that Joule heat is transferred from the pair of blades to the mucosal tissue to be incised, allowing sufficient time for the mucosal tissue to rise in temperature, evaporate water, and coagulate. It is necessary. However, if the incision time is slightly longer, the temperature rise of normal tissue at the time of incision becomes too large, which may cause delayed perforation at the incision site.

The present invention has been made to solve the above problems, and even if the incision time is longer than before, a sufficient amount of Joule heat is transferred from the blade to the boundary between the lesion site and the normal tissue. It is possible to realize a hematopoietic incision that achieves the trade-off between keeping the amount of Joule heat transferred to the normal tissue side of the living tissue small, and the incision time can be longer than before, and the boundary site. By taking sufficient time to raise the temperature of the mucosal tissue, evaporate water, and coagulate, the sharpness of the incision can be improved, and there is no risk of slow-acting perforation at the incision site. The purpose is to provide incision shears.

The electrocautery scissors for endoscopes according to the first aspect of the present invention have a flexible sheath that can be inserted into and removed from the channel of the endoscope and can move back and forth into the sheath in order to achieve the above object. The operation wire arranged in the sheath, the operation portion connected to the rear end side of the operation wire and the sheath to advance and retreat the operation wire, and the cylinder portion provided at the tip portion of the sheath and the tip side of the cylinder portion. It has a treatment portion supporting means having a pair of opposed arms extending to the surface, and a pair of scissors pieces, and the middle portion of each of the scissors pieces overlaps between the pair of arms and the pair of arms. It is rotatably supported by a support shaft provided so as to penetrate through the scissors, and the rear end side portion of each of the scissors pieces opens and closes in response to the advancing / retreating motion force of the operation wire. The tip side portion opens and closes, and only the blade portion of the tip side portion of each of the scissors pieces is provided so as not to have an insulating coating and is not in contact with each other, and at least one of the pair of scissors is an electrode. An electrocautery scissors for endoscopy provided with scissors for incising the affected part of living tissue by applying a voltage, and the tip end side portion of each of the scissors pieces is a streak portion provided as the blade portion. And, the scissors open / close direction rearward with respect to the scissors, extending from the middle part in an arch shape to support the base end portion and the tip end portion of the streak portion, and between the base end portion and the tip portion, the said It is characterized by having an arched support frame that is separated from the streaks.

In the endoscopic electrocautery incision scissors according to the second aspect of the present invention, in the first aspect described above, the streak portion is a conductive wire rod or stranded wire different from the arch-shaped support frame. The arched support frame may be joined and supported by welding, brazing, or soldering to the base end portion and the tip end portion, respectively.

The endoscopic electrocautery incision shears according to the third aspect of the present invention have, in the second aspect, the side surface portions of each of the arch-shaped support frames opposite to each other with respect to the arch-shaped support frame. The base end and the tip are formed with recesses, and the base end and the tip of the streak are accommodated in the recesses and the recesses of the tip, and are joined by welding, brazing, or soldering. It can be a supported configuration.

In the endoscopic electrocautery incision scissors according to the fourth aspect of the present invention, in the first aspect described above, the streaks and the arch-shaped support frame are cut into a conductive material. It can be an integrally formed configuration.

According to the present invention, even if the incision time is longer than before, a sufficient amount of Joule heat is transferred from the blade to the boundary site between the lesion site and the normal tissue, and the living tissue is transferred to the normal tissue side. It is possible to realize a hemostatic incision that achieves the trade-off between suppressing the amount of Joule heat transfer to a small size, and the incision time can be longer than before, the temperature of the mucosal tissue at the boundary site rises, and the water evaporates. By taking a sufficient time for coagulation, the sharpness at the time of incision can be improved, and it is possible to provide an electrocautery incision shear for endoscopy that does not cause a delayed perforation at the incision site.

It is a figure for demonstrating the endoscopic system including the electric ablation incision scissors for an endoscope which concerns on 1st Embodiment of this invention. It is an overall view of the electric ablation scissors for an endoscope which concerns on the 1st Embodiment of this invention. It is a partially cross-sectional front view which shows the state which the scissors piece part of the electric ablation incision scissors for an endoscope which concerns on 1st Embodiment of this invention is open. It is a partially cross-sectional front view which shows the state which the scissors piece part of the electric ablation incision scissors for an endoscope which concerns on 1st Embodiment of this invention is closed. It is a perspective view which shows the state which the scissors piece part of the electric ablation incision scissors for an endoscope which concerns on 1st Embodiment of this invention is open. It is explanatory drawing which shows the place where the incision is made by the electric ablation incision scissors for an endoscope which concerns on 1st Embodiment of this invention. It is a streak part of a modified example applied to the electrocautery incision scissors for an endoscope according to the first embodiment of the present invention. It is a partially cross-sectional front view which shows the state which the scissors piece part of the electric ablation incision scissors for an endoscope which concerns on 2nd Embodiment of this invention is open.

Hereinafter, embodiments relating to the electrocautery incision scissors for an endoscope according to the present invention will be described with reference to the drawings. In this embodiment, the side where the scissors are located is called the front end side, and the side where the operation unit is located is called the rear end side.

[Embodiment 1]
[Endoscope system]
FIG. 1 shows an endoscopic system to which the electrocautery incision scissors for an endoscope according to the first embodiment is applied. The endoscope system 1 includes an insertion unit 2 that is inserted into the body cavity of a living body, an endoscope operation unit 3 that has a dial and operates the dial to bend the tip of the insertion unit 2 in the vertical and horizontal directions. It is provided with a treatment tool introduction part 4 having a branched structure arranged so as to connect between the insertion part 2 and the endoscope operation part 3, and the inside of the insertion part 2 from the treatment tool introduction part 4 is longitudinally directed toward the insertion tip. The endoscopic channel 5 formed in the endoscope is formed, and the shear portion (treatment portion) 16 and the sheath 11 of the endoscopic electrocautery incision shear (endoscopic treatment tool) 10 are inserted into the endoscope channel 5. It is configured to do.

[Basic configuration of electrocautery incision shears 10 for endoscopes]
As shown in FIG. 2, the endoscopic electrocautery incision scissors 10 are arranged with a flexible elongated sheath 11 that is inserted into and removed from the endoscopic channel 5 and inserted into the body so as to be able to move forward and backward in the sheath 11. The operation wire 12 is operated, the operation portion 13 for advancing and retreating the operation wire 12 on the rear end side, the treatment portion support means 14 provided at the tip of the sheath 11, and the treatment portion support means 14 are rotated by the support shaft 15. It includes a scissors portion 16 that is movably supported and makes an incision in a living tissue.

Hereinafter, the configuration of the electrocautery incision scissors 10 for an endoscope will be described in more detail with reference to FIGS. 3, 4, 5 (a) and 5 (b).

The sheath 11 is an elongated tubular body having flexibility and appropriate waist strength (bending resistance), and for example, a coil sheath formed by tightly winding a metal material such as a stainless wire may be used. Preferably, the length is 500-2000 mm. The sheath 11 may be composed of a coil sheath and a flexible resin outer cover that covers the outer surface of the coil sheath, and further, a flexible tube such as PTE, PEEK, PPS, polyethylene, or polyimide. It may be composed of only.

The operation wire 12 is a torque wire that is loosely arranged in the sheath 11 so as to be able to move forward and backward, and is conductive and has a large rotational followability. The operation wire 12 may have, for example, a total length made of stainless steel, or may be made of stainless steel on the rear end side and nitinol (nickel titanium alloy) on the front end side, and both are connected by a stainless steel pipe.

The operation unit 13 is connected to the rear end side of the operation wire 12 and the sheath 11, and is configured to advance and retreat the operation wire 12.

The operation unit 13 slides the slider 13a attached to the base end of the operation wire 12 and the operation unit main body 13b attached to the base end of the sheath 11 relative to each other (advance / retreat operation), whereby the operation wire 12 Is movable in the longitudinal direction, and the operation wire 12 is configured to be moved to the tip side by moving the slider 13a to the left direction (tip side) in the drawing.

The treatment portion supporting means 14 has a tubular portion 14a connected and fixed to the tip portion of the sheath 11, and a pair of arm portions 14b extending in a bifurcated manner from the tip portion of the tubular portion 14a. The tubular portion 14a is fitted to the tip end portion of the sheath 11 and further connected and fixed by brazing, soldering, bonding or crimping. The treatment portion supporting means 14 can be formed, for example, by slitting a stainless steel tube having a required small diameter and a required length from one end.

The scissors portion 16 has a pair of left and right opposite scissors pieces 17, 18 that overlap in an X shape. The pair of scissors pieces 17 and 18 are positioned so that the intermediate portions 17a and 18a overlap each other in an X shape between the pair of arm portions 14b, and the support shaft 15 can rotate through the intermediate portions 17a and 18a. Both ends of the support shaft 15 penetrate the pair of arm portions 14b and are fixed to the pair of arm portions 14b. The pair of scissors pieces 17, 18 are made of, for example, stainless steel or nitinol (nickel titanium alloy).

The rear end portions 17b, 18b of the pair of scissors pieces 17, 18 that are closer to the rear end side than the support shaft 15 are pin-connected to the pair of opening / closing operating links 17d, 18d, and further, the pair of opening / closing operating links 17d, 18d is pin-connected to the advance / retreat transmission link 19, and the advance / retreat transmission link 19 is connected and fixed to the tip of the operation wire 12.

Therefore, the portions 17c and 18c on the tip side of the pair of scissors pieces 17 and 18 with respect to the support shaft 15 are configured to open and close as follows. First, when the operation wire 12 is moved to the front end side, the pair of opening / closing operating links 17d and 18d are operated so that the leg opening angle is large, so that the rear end side portions 17b and 18b move the operation wire 12 forward and backward. When the pair of scissors pieces 17 and 18 are opened by receiving a force, the portions 17c and 18c on the tip side of the support shaft 15 of the pair of scissors pieces 17 and 18 are opened. On the other hand, when the operation wire 12 is moved to the rear end side, the pair of opening / closing operating links 17d and 18d operate so that the leg opening angle becomes smaller, so that the rear end side portions 17b and 18b advance and retreat the operation wire 12. As the leg opening angle becomes smaller due to the moving force, the tip side portions 17c and 18c of the pair of scissors pieces 17 and 18 with respect to the support shaft 15 are closed. Therefore, by moving the operation wire 12 forward and backward, the distal end side portions 17c and 18c of the pair of scissors pieces 17 and 18 are opened and closed to perform an incision operation of the living tissue in the body cavity.

The slider 13a has a connection terminal 21. The connection terminal 21 is supplied with a high-frequency current or the like from, for example, a high-frequency power supply device, a low-voltage incision waveform current power supply device, or an ultrasonic oscillator, and a pair of open / close operations are performed via an operation wire 12 connected to the connection terminal 21. A high frequency current or the like is supplied to the links 17d and 18d.

Ensuring electrical insulation will be described. Insulating coatings are provided on the inner and outer surfaces of the sheath 11. The treatment portion supporting means 14 is provided with an insulating coating on the outer surface. The scissors piece portion 17 and the scissors piece portion 18 are electrically insulated from each other by being provided with an insulating film on the outer surface except for the blade portions of the tip side portions 17c and 18c. A spacer made of an insulating material is sandwiched between the scissors piece 17 and the scissors piece 18, or a boss portion is provided on one of the scissors piece 17 and the scissors piece 18 to provide an insulating film, and the scissors piece 17 is provided. For example, it is preferable to provide a gap of 0.2 to 0.3 mm between the scissors piece portion 18 and the scissors piece portion 18. The opening / closing operation link 17d and the opening / closing operation link 18d are each provided with an insulating coating on their outer surfaces and are electrically insulated from each other. The scissors piece portion 17 and the opening / closing operation link 17d are in a state of being electrically connected, and the scissors piece portion 18 and the opening / closing operation link 18d are in a state of being electrically connected. The insulating coating is preferably made of a so-called inert synthetic resin material having high chemical and thermal stability, such as fluororesin. Then, the outer surface of the sheath 11, the outer surface of the treatment portion supporting means 14, and the outer surface of the scissors portion 16 are further hydrophilic to the outer surface of the insulating coating so that smooth insertion can be performed without friction when inserted into the body cavity. Gender is given. If a polymer material such as polyimide, nylon, POM, or PTFE, which does not easily seize the mucous membrane and has good slipperiness, is coated as the insulating film, hydrophilicity can be imparted at the same time.

[Characteristic configuration of electrocautery incision shears 10 for endoscopes]
The tip-side portions 17c and 18c of the scissors pieces 17 and 18 are arch-shaped midway portions 17a rearward in the scissors opening / closing direction with respect to the streaks 25 and 26 provided as blades and the scissors 25 and 26. , 18a, the arch-shaped support frame 27 that supports the base end a and the tip b of the streaks 25 and 26 and is separated from the streaks 25 and 26 between the base end a and the tip b. , 28 and.

The wire strips 25 and 26 are made of a conductive wire rod that is hard to break and rust and is different from the arched support frames 27 and 28, for example, titanium wire, stainless steel wire, or spring wire. The portions where the arch-shaped support frames 27 and 28 support the base ends and the tips of the streaks 25 and 26 are the base ends and the tips of the side surfaces opposite to each other with respect to the arch-shaped support frames. Is. Then, recesses are formed in each of the base end portion and the tip end portion of the side surface portion, and the base end portions and the tip end portions of the linear portions 25 and 26 are accommodated in the pair of recesses, and welding, brazing, or soldering is performed. It is bonded and supported by. The streaks 25 and 26, which are the blades, have no insulating coating, and the arch-shaped support frames 27 and 28 have an insulating coating.

[Action / effect based on the characteristic configuration of electrocautery incision shears 10 for endoscopes]
At the time of incision, first, hyaluronic acid or the like is injected under the affected area in advance to make the lesion site raised from the normal tissue. Next, by remote operation on the proximal end side, as shown in FIGS. 6 (a) and 6 (b), it is necessary to sandwich the boundary site between the lesion site and the normal tissue between the pair of streaks 25 and 26. An incision is made while stopping bleeding so as to ablate by applying a current (for example, high-frequency current, low-voltage incision waveform current, ultrasonic wave, etc.) to remove the lesion site. The incision by the electrocautery incision shears 10 for endoscopy does not cut the living tissue by the shearing force, but the high-frequency voltage (or low-voltage incision waveform voltage, microwave) is applied to the living tissue sandwiched between the streaks 25 and 26. , Ultrasonic, etc.) is applied to cauterize and cut the living tissue, and even if the living tissue is lightly pinched, the incision is not made immediately, so even though it is a scissors, bleeding is reduced and the mucous membrane is covered. The incision can be performed carefully by applying a high-frequency voltage or the like while visually observing the contacting streaks 25 and 26. As shown in FIG. 6A, the streaks 25 and 26 supported by the arch-shaped support frames 27 and 28 approaching each other in the direction of the arrow form a lesion site prior to the arch-shaped support frames 27 and 28. It approaches the boundary with normal tissue. The arch-shaped support frames 27 and 28 are configured to pass each other in close proximity, and the streak portions 25 and 26 are provided on the outer surface portions of the arch-shaped support frames 27 and 28, and thus are shown in FIG. 6 (b). As described above, there is a separation distance when passing each other, but since this separation distance is less than 1 mm, the striations 25 and 26 can close the incision. The trailing arched support frames 27, 28 suppress the movement of normal tissue toward the lesion site.

The Joule heat transmitted from the striatum 25 and 26 is transmitted not only to the boundary site between the lesion site and the normal tissue but also to the normal tissue side, but the Joule heat transmitted to the normal tissue side heats the mucosal tissue on the surface of the normal tissue. It will expand. However, since there is a gap between the linear portion 25 and the arch-shaped support frame 27 and there is a gap between the linear portion 26 and the arch-shaped support frame 28, the Joule heat transferred to the normal tissue side is transferred to the arch-shaped support frame 27. , 28 does not confine to the normal tissue side, but changes the mucosal tissue into a large amount of bubbles F from the gap between the striatum 25, 26 and the arched support frames 27, 28, and is accompanied by heat transfer in the excision direction. It will move to the lesion site side. For this reason, the amount of Joule heat transferred to the normal tissue is significantly reduced as compared with the conventional configuration example (for example, the scissors pieces 12 and 22 having the blade portions 13 and 23 as in the configuration of Patent Document 1), so that the incision is made. Even if the time is slightly lengthened, a larger amount of foam F is formed and heat is transferred, so that the temperature rise of normal tissue at the time of incision is suppressed from becoming too large, and there is a risk of slow-acting perforation at the incision site. Is resolved.

In the bipolar type current supply, both the wire portions 25 and 26 are electrodes, and in the monopolar type current supply, one of the wire portions 25 and 26 is an electrode. Since there is a gap between the striatum 25,26 and the arched support frames 27,28, the striatum 25,26 can be moved to the boundary between the lesion site and the normal tissue. Since the arch-shaped support frames 27 and 28 do not exist between 26, even if the monopolar type is used, the time for Joule heat to be transferred to the mucosal tissue becomes long, which is sufficient for the temperature rise of the mucosal tissue, evaporation of water, and coagulation. You can make a smooth incision because you have time.

That is, the incision time is made longer than before to provide a sufficient amount of Joule heat transfer from the blade to the boundary site between the lesion site and the normal tissue, and Joule heat transfer to the normal tissue side of the living tissue. It is possible to realize a hemostatic incision that achieves the trade-off between keeping the amount of heat small, and it is possible to take a longer incision time than before and improve the sharpness when performing the incision.

[Modification example of characteristic configuration of electrocautery incision shears 10 for endoscope]
As shown in FIG. 7, the strips 25 and 26 are gold-plated or silver-plated on a conductive stranded wire, for example, a stranded wire made of a stainless steel wire or a spring wire, which is separate from the arch-shaped support frames 27 and 28. You may replace it with the one that is made of. When the stranded wire is used, the sharpness is further improved due to the unevenness of the surface.

[Embodiment 2]
[Basic configuration]
FIG. 8 shows an electrocautery incision scissors for an endoscope according to a second embodiment. The basic configuration of the endoscopic electrocautery incision shears 10A differs in the following points. In the endoscopic electrocautery incision scissors 10A of the second embodiment, the scissors portion 16A does not have the opening / closing actuating links 17d and 18d and the advancing / retreating transmission link 19 shown in FIG. 3, but has two scissors in the sheath 11A. The operation wires 12A and 12B are passed through. The tips of the two operating wires 12A and 12B project between the arms 14b of the treatment portion supporting means 14A provided at the tip of the sheath 11A, and the intervals are gradually widened to be rear of the pair of scissors pieces 17A and 18A. It is connected to the rear end portions of the end side portions 17b and 18b. Therefore, in the pair of scissors pieces 17A and 18A, the two operating wires 12A and 12B move forward and backward integrally, and the spread angle of the tip portions of the two operating wires 12A and 12B is expanded and contracted. The tip side portions 17c and 18c of the single portions 17A and 18A are designed to open and close. The two operating wires 12A and 12B also serve as feed lines, and are sufficiently insulated from each other so as not to cause an electrical short circuit. The sheath 11A is covered with an insulating tube. The same parts as those in the first embodiment are designated by the same reference numerals as those in the first embodiment.

[Characteristic configuration of electrocautery incision shears 10 for endoscopes]
The characteristic configuration of the second embodiment is that the streaks 25A and the arched support frame 27A, which are the tip side portions 17c and 18c of the scissors pieces 17A and 18A, and the streaks 26A and the arched support frame 28A are separate bodies. It is not a structure, but is integrally formed by making cuts 29 and 30 in a conductive material.

The action and effect of the endoscopic electrocautery incision shears 10A of the second embodiment is the same as the action and effect of the endoscopic electrocautery incision shears 10 of the first embodiment.

According to the present invention, even if the incision time is longer than before, a sufficient amount of Joule heat is transferred from the blade to the boundary site between the lesion site and the normal tissue, and the living tissue is transferred to the normal tissue side. It is possible to realize a hemostatic incision that achieves the trade-off between suppressing the amount of Joule heat transfer to a small size, and the incision time can be longer than before, the temperature of the mucosal tissue at the boundary site rises, and the water evaporates. By taking sufficient time for coagulation, the sharpness when making an incision can be improved, and there is no risk of slow-acting perforation at the incision site, which is an excellent electrocautery incision shear for endoscopy. Can be provided.

1 Endoscope system 2 Insertion part 3 Endoscope operation part 4 Treatment tool introduction part 5 Endoscope channel 10,10A Endoscopic electrocautery incision scissors 11,11A Sheath 12, 12A, 12B Operation wire 13 Operation part 13a Slider 13b Operation part body 14,14A Treatment part Support means 14a Tube part 14b Arm part 15 Support shaft 16,16A Scissors part 17,18,17A, 18A Scissors piece part 17a, 18a Midway part 17b, 18b Rear end side part 17c, 18c Tip side part 17d, 18d Open / close operation link 19 Advance / retreat transmission link 2 1 Connection terminal 23,24 Feed line 25, 25A, 26, 26A Wire strip 27, 27A, 28, 28A Arched support frame 29A Notch a Base end Part b Tip

Claims (4)

A flexible sheath that can be inserted into and removed from the endoscopic channel,
An operation wire arranged so as to be able to move forward and backward in the sheath,
An operation unit connected to the rear end side of the operation wire and the sheath to advance and retreat the operation wire,
A treatment portion supporting means having a tubular portion provided at the tip end portion of the sheath and a pair of opposed arm portions extending toward the distal end side from the tubular portion.
It has a pair of scissors pieces, and the middle part of each of the scissors pieces is rotatably supported by a support shaft provided so as to overlap between the pair of arms and penetrate the pair of arms. The rear end side portion of each of the scissors pieces opens and closes by receiving the advancing / retreating motion force of the operation wire, so that the tip end side portion of each of the scissors pieces opens and closes, and the blade of the tip end side portion of each of the scissors pieces. Only the parts are provided so as not to have an insulating coating and are not in contact with each other, and at least one of the pair of blade parts serves as an electrode and is provided with scissors parts to which a required voltage is applied to incise the affected part of the living tissue. Electric scissors for mirrors
The tip side portion of each of the scissors pieces
The streaks provided as the blade and
The streak extends from the middle part in an arch shape rearward in the opening / closing direction of the scissors with respect to the streak portion to support the base end portion and the tip end portion of the streak portion and between the base end portion and the tip end portion. With an arched support frame away from the section,
An electrocautery incision scissors for endoscopes, which is characterized by this. The strip is made of a conductive wire or stranded wire separate from the arched support frame, and is welded, brazed, or soldered to the base end and the tip of the arched support frame, respectively. The electrocautery incision scissors for an endoscope according to claim 1, wherein the scissors are coupled and supported by an endoscope. Recesses are formed in the base end portion and the tip end portion of the side surface portion opposite to the arch shape support frame on the opposite side of each of the arch-shaped support frames, and the line is formed in the recessed portion of the base end portion and the recessed portion of the tip portion. The electrocautery incision scissors for an endoscope according to claim 1, wherein the base end portion and the tip end portion of the strip portion are housed and jointly supported by the welding, brazing, or soldering. The electrocautery incision scissors for an endoscope according to claim 1, wherein the streak portion and the arch-shaped support frame are integrally formed by making a notch in a conductive material.

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