JP2533616Y2 - Stone crushing equipment - Google Patents

Description

[Detailed description of the invention]

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a calculus crushing device for crushing calculus formed in a body cavity.

[0002]

2. Description of the Related Art Stone formation in organs such as the biliary tract and the bladder adversely affects patients. In particular, an enlarged stone causes extremely great pain to the patient. Therefore, a treatment for introducing a calculus crushing device into a body cavity by using an endoscope, crushing a calculus generated in the body cavity, and discharging or removing the calculus from the body is performed.

[0003] As a calculus crushing device used for this kind of treatment, there is one known in Japanese Patent Publication No. 63-20140. This provides a basket at the tip of the operation wire,
The basket is inserted into the flexible sheath together with the operation wire, and the operation section connected to the rear end of the flexible sheath pushes and pulls the operation wire forward and backward to capture stones in the basket, It crushes the stones by crushing the basket.

When a calculus is taken into a basket and crushed, for example, the basket may be caught in the bile duct, and the operation wire may not be able to be pulled out of the bile duct as it is. Remove the endoscope and the flexible sheath from the body, insert a new flexible sheath, connect the operation unit to pull the operation wire, wind up the operation wire with a handle, etc. There are also devices that crush stones with stronger crushing power. As such a device, a unique DE 33343231 (C2)
There is.

[0005]

However, when crushing with the latter device, the operation unit is heavy and the operation procedure is complicated. In addition, even when the basket cannot be removed, the endoscope or sheath is removed, and the sheath and the operation unit are newly connected and crushed, so that the procedure is complicated and the operation time is long. there were.

[0006] The present invention has been made in view of the above-mentioned problems. The purpose of the present invention is to easily hold a calculus, and then without removing an endoscope or the like from the body.
An object of the present invention is to provide a calculus crushing device capable of crushing more strongly by using means for pulling an operation wire.

[0007]

In order to solve the above-mentioned problems, a calculus crushing device according to the present invention is configured such that an operation wire is inserted into a sheath having a hard portion at a tip end so as to be able to advance and retreat, and a plurality of operation wires are inserted at the tip of the operation wire. A basket composed of an elastic wire is provided, an operating section having a rotatable handle is connected to the base end of the sheath, and the operating wire is pulled to the operating section in conjunction with the movement of the handle. Means are provided, and a grip portion for moving the operation wire forward and backward when the handle is not rotated is connected to a base end of the operation wire.

[0008] Then, by moving the gripping portion forward and backward, the calculus is reliably taken into the basket, and after the grip is fixed, the handle is rotated to pull the operation wire and the basket is reduced, thereby immediately breaking the calculus. It is made possible.

[0009]

1 to 4 show a first embodiment of the present invention. As shown in FIG. 1, the calculus crushing apparatus includes a flexible sheath 1 composed of a closely wound coil or the like. A cylindrical hard member is fixedly attached to the distal end of the sheath 1, thereby forming a hard portion 2. An operating section main body 3 is fixedly attached to the proximal end of the sheath 1. The operation unit main body 3 has a storage chamber 4 formed therein. Through holes 4a and 4b communicating with the storage chamber 4 and matching the axial direction of the sheath 1 are formed in front and rear walls of the storage chamber 4. Is formed. The front through-hole 4a is formed over the cylindrical portion 3a connecting the rear end of the sheath 1.

A support bearing 5a is provided on one surface of the upper and lower inner walls in the storage chamber 4 of the operation section main body 3, and a winding support is provided on the other wall in a direction perpendicular to the axial direction of the sheath 1. A bearing hole 5b through which the shaft 6 passes is provided. One end of the support shaft 6 is supported by being supported by a support bearing 5a, and the other end of the support shaft 6 penetrates through the bearing hole 5b and protrudes upward from the operation unit main body 3. A handle 7 is attached to a protruding outer end of the support shaft 6. The support shaft 6 is provided with a retaining collar 8 at a position facing the support bearing 5 a of the storage chamber 4. Further, the support shaft 6 has the through holes 4a, 4a.
An insertion hole 6a coinciding with the axis of b is formed.

On the other hand, an operation wire 9 is provided in the sheath 1.
Is inserted. A basket 10 is provided at the tip of the operation wire 9. This basket 10 binds the front and rear ends of a plurality of elastic wires 11 with different chips 12a and 12b, respectively.
By forming a plurality of bent portions 13 in the middle part, the operation wire 9 is formed in a cage shape that can be extended and contracted in the axial direction of the operation wire 9, that is, can be opened and closed.

A relatively hard operating pipe 14 is fitted on the base end of the operating wire 9. The operation pipe 14 protrudes from the operation section main body 3 through an insertion hole 6 a provided in the support shaft 6. A grip 16 for pushing and pulling operation is connected and fixed to the base of the operation pipe 14. Further, the holding portion 16 is provided with a fixing member 17 such as a set screw for tightening and fixing the base end of the operation wire 9. When the fixing member 17 is loosened, the fixing of the operation wire 9 can be released. An O-ring 18 is provided on the inner surface of the cylindrical portion 3a of the operation section main body 3 to be joined to the outer periphery of the operation pipe 14. O-ring 1
The holding means 8 not only seals the space between the sheath 1 and the operation section main body 3 but also maintains the operation pipe 14 and the operation wire 9 at that position by a frictional force at the time of sliding contact. The calculus crushing device thus configured is introduced endoscopically into a body cavity, protrudes from the distal end of the endoscope, and is inserted into, for example, a duodenal papilla into a bile duct.

Until the introduction is completed, the basket 10
Are housed inside the sheath 1. Then, after finding the calculus A in the body cavity, as shown in FIG. 4A, the grip 10 is pushed in and the operation wire 9 is advanced, so that the basket 10 is projected from the distal end of the sheath 1. Let it open. When the basket 10 is opened, the calculus A is taken into the inside of the basket 10 through the gap between the elastic wires 11, and then the grip portion 16 is retracted to remove the basket 10 as shown in FIG. Shrink.

If the calculus A held in the basket 10 in this way is too small to be pulled out of the bile duct, as shown in FIG.
7 is released, the operation wire 9 is released, and the gripper 16 is retracted, whereby the operation pipe 14 is withdrawn. The operation wire 9 remains as shown in FIG.
It protrudes from the operation unit main body 3 through an insertion hole 6 a provided in the support shaft 6.

Thereafter, as shown in FIG. 4D, when the handle 7 is rotated, the operation wire 9 is wound around the outer periphery of the support shaft 6. Since the middle of the base end portion of the operation wire 9 is wound around the support shaft 6, it is strongly pulled. Then, the basket 10 is drawn into the distal end portion of the sheath 1 and contracted by the pulling means.
To be crushed.

As described above, after the calculus A is taken into the basket 10 by the advancing / retreating operation of the grip portion 16, the grip portion 16 is removed, the handle 7 is rotated, and the operation wire 9 is moved.
Can be towed and crushed.

FIGS. 5 and 6 show a second embodiment of the present invention. In this embodiment, the operation wire 9
The means of pulling is different. That is, as shown in FIG. 5A, the first gear 19 is provided in the storage chamber 4 of the operation section main body 3.
And a second gear 20 are arranged vertically above and below the operation pipe 14, and the respective gears 19 and 20 are attached to respective support shafts 21 and 22 along a direction perpendicular to the longitudinal axis direction of the sheath 1. Have been. The first support shaft 21 supporting the first gear 19 is supported at a fixed position by the operation section main body 3.

On the other hand, both ends of the second support shaft 22 that supports the second gear 20 protrude outside through a slot 23 provided in the operation section main body 3. This second support shaft 2
As shown in FIG. 6B, a spindle fixing member 24 is screwed and attached to one end of the handle 2, and a handle 7 is attached to the other end.
Is attached. The support shaft fixing member 24 fixes the second support shaft 22 to the operation section main body 3 by screwing.

Each of the left and right slots 23 is formed symmetrically with the same arc, and a second support shaft for supporting the second gear 20 at one end of the slots 23 as shown in FIG. When 22 is located, its first gear 19 and second gear 20 mesh. In addition, as shown in FIG.
When the second support shaft 22 supporting the second gear 20 is located at the other end of the first gear 19, the second gear 20 is connected to the first gear 19
Evacuates from and does not engage. The central part of the slot 23 is located higher than the position of each end. Each end of the slot 23 is located at a position where it is completely lowered, so that the second support shaft 22 falls down at each end of the slot 23 and has a stable relationship. Other configurations are the same as those of the first embodiment described above, and the description thereof will be omitted.

Therefore, as in the case of the first embodiment, for example, when a calculus (not shown) is taken into the basket, the calculus shown in FIG.
(A), the second support shaft 22 has a groove 23a.
Of the first gear 19 and the second gear
Does not mesh with the gear 20 and also retracts from the outer periphery of the operation pipe 14. The second gear 20 can be fixed at that position by tightening the support shaft fixing member 24.

Therefore, the operating pipe 14 can be moved forward and backward by operating the grip portion 16. Then, after the calculus is gripped by this operation, the grip 16 is retracted, and the basket is reduced.

Thereafter, as shown in FIG. 5 (b), the fixing member 17 is loosened to release the operation wire 9, the grip 16 is pulled out, and the operation pipe 14 is pulled out. However, the operation wire 9 passes through the storage chamber 4 of the operation section main body 3 and
It remains in a state protruding from the surface.

Next, as shown in FIG. 5C, the support shaft fixing member 24 is released, and the second support shaft 22 is moved along the groove 23b to the other end while the handle 7 is gripped. Let it.
Then, the second gear 20 meshes with the first gear 19.
The operation wire 9 is sandwiched between the surfaces where the first gear 19 and the second gear 20 mesh. It is fixed at this position by the support shaft fixing member 24, and thereafter, as shown in FIG.
When the handle 7 is rotated in a direction in which the operation wire 9 is retracted, the operation wire 9 is located on the surface where the first gear 19 and the second gear 20 are engaged. 9 is retracted and towed, so that the basket (not shown) is reduced in the same manner as in the case of the above-described first embodiment, and the calculus taken in the basket can be crushed.

Since the operation wire 9 is only on the meshing surface by the first gear 19 and the second gear 20, if the crushed stone is not enough in one calculus crushing operation, the operation wire can be easily formed. 9 can be released. And again, the gripper 1
6 can be connected to take the calculus into the basket and break the calculus.

FIG. 7 shows a third embodiment of the present invention. This embodiment is a modification of the second embodiment,
The second support shaft 22 that supports the second gear 20 is a cantilever support, and only one end of the second support shaft 22 protrudes from the operation unit main body 3 and is fixed by a support shaft fixing member 24. On the other hand, the first gear 19 has fewer teeth and the second gear 2
A third gear 25 meshed with the first gear 25 is provided, and the third gear 25 is supported by a third support shaft 26.

At the other end of the third support shaft 26, at a position facing the support shaft fixing member 24 of the operation section main body 3, it protrudes out of the wall of the operation section main body 3, and the handle 7 is attached to this protruding end. Thus, the third gear 25 can be rotated. The other configuration is the same as that of the above-described second embodiment, and the detailed description is omitted.

Therefore, in this embodiment, when a calculus is taken into a basket (not shown) and the calculus is broken, the following difference is made, and the other points are the same as in the case of the second embodiment. . That is, when taking a calculus into a basket (not shown) and breaking it, the handle 7 is rotated so that the operation wire 9 is retracted. Since the number of teeth of the third gear 25 is smaller than that of the second gear 19, the rotation is reduced and transmitted to the second gear 20. Then, the operation wire 9 meshed with the first gear 19 and the second gear 20 is reduced in speed and retreats.

However, since the operation wire 9 is decelerated and retreated, when the calculus is broken, fragments are not scattered vigorously, so that the lumen is not damaged. Further, the crushing force can be increased.

FIGS. 8 and 9 show a fourth embodiment of the present invention. In this embodiment, when the basket 10 is constituted by, for example, four elastic wires 27, 28, 29, and 30, the first elastic wire 27 is constructed by forming the basket 10 and then penetrating through the rear chip 12b. Wire 9
Becomes one strand 9a. Also, the second elastic wire 2
8, the base of the third elastic wire 29 is inserted and fixed to substantially the center of the rear chip 12b.

On the other hand, the tips of the other two strands 9b and 9c constituting the operation wire 9 are inserted into the tip 12b, and the leading end is fixed at the center of the tip 12b. The operation wire 9 is composed of those wires 9a, 9b, 9c.
It is bundled. The base end of the fourth elastic wire 30 is aligned with the position of the rear end 31 of the chip 12b and joined to the chip 12b.

In the basket 10 configured as described above,
When breaking a calculus, the first, second, third and fourth elastic wires 2
Since 7, 28, 29, and 30 are uniformly located in the inner hole of the chip 12b, the breaking force at that time is uniformly distributed. Therefore, the first, second, third, and fourth elastic wires 27, 2
8, 29, 30 are less likely to break. The present invention is not limited to the above-described embodiments, and various modifications can be made without departing from the scope of the invention.

[0032]

According to the present invention, as described above, the calculus can be easily taken into the basket and gripped by operating the operation gripping portion forward and backward. After the grip, the handle provided on the operation unit is rotated, and the operation wire is pulled, whereby the calculus can be reliably gripped and crushed more strongly. Further, since the operation wire can be pulled without removing the endoscope or the like, the operation procedure is simple.

[Brief description of the drawings]

FIG. 1 is a sectional view schematically showing an overall configuration of a first embodiment of the present invention.

FIG. 2 is a cross-sectional view showing a configuration in the vicinity of a front end portion of the first embodiment of the present invention.

FIG. 3 is a cross-sectional view showing the configuration of the first embodiment of the present invention in a state where an operation grip is removed.

FIG. 4 is an explanatory view sequentially showing the operation procedure of the first embodiment of the present invention.

FIG. 5 is a sectional view sequentially showing a configuration near an operation unit and an operation procedure according to a second embodiment of the present invention.

FIG. 6A is a cross-sectional view of the vicinity of an operation unit according to the second embodiment of the present invention, and FIG. 6B is a cross-sectional view taken along line II in FIG.

FIG. 7A is a cross-sectional view near an operation unit according to a third embodiment of the present invention, and FIG. 7B is a cross-sectional view taken along line II-II in FIG.

FIG. 8 is a sectional view showing the vicinity of a rear end tip of a basket according to a fourth embodiment of the present invention.

9A is a sectional view taken along line III-III in FIG.
(B) is a sectional view taken along line IV-IV in FIG. 8.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... sheath, 2 ... hard part, 3 ... operation part main body, 7 ... handle, 9 ... operation wire, 10 ... basket, 11 ... elastic wire, 14 ... operation pipe, 16 ... gripping part.

Claims (1)

(57) [Scope of request for utility model registration] A basket having a sheath having a rigid portion at a distal end thereof, an operation wire inserted through the sheath so as to be able to advance and retreat, a plurality of elastic wires connected to the distal end of the operation wire, and the sheath. An operation unit connected to the base end of the device, a handle rotatably provided on the operation unit,
Means for pulling the operation wire in association with the movement of the handle provided on the operation unit; and a grip unit connected to a base end of the operation wire for operating the operation wire forward and backward when the handle is not rotating. A calculus crushing device characterized by the following.