JP2604081B2 - Endoscope treatment tool - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a treatment instrument for an endoscope such as a high-frequency snare or a grasping forceps used transendoscopically.

[0002]

2. Description of the Related Art Generally, an insertion portion of a treatment tool for an endoscope is constituted by coating a resin tube on an outer periphery of a sheath made of a metal coil closely wound. For example, a high-frequency treatment device for an endoscope known in Japanese Patent Application Laid-Open No. 1-204664 is a high-frequency treatment device that applies a high frequency and performs a treatment such as cauterization incision on a site in a body cavity.
The insertion portion is also formed by covering an outer periphery of a sheath made of a closely wound metal coil with an electrically insulating tube.

[0003]

However, in general, the insertion portion of the treatment instrument for an endoscope is of a type in which the tube is simply covered on the outer periphery of the inner sheath and fixed. In the case of JP-A-1-204664,
At least the distal end portion of the outer sheath is tightly fixed to the outer periphery of the inner sheath by thermoforming to integrate them, but the fixing strength therebetween is not so large. For this reason, when used for a long period of time at a considerable frequency, for example, there is a possibility that the adhered portions of the two may come off.

[0004] In particular, in this type of endoscope treatment instrument, there is a situation in which the fixed portions of the two are particularly easily peeled off due to the following special use conditions. In other words, it is used by being inserted into the body cavity through the treatment tool insertion channel of the endoscope previously inserted into the body cavity, and in this case, the loop of the treatment tool insertion channel of the endoscope is used. Accordingly, the endoscope treatment tool is also curved.

[0005] At this time, the inner sheath is relatively elongated and a tensile force is applied to the outer sheath due to a difference in the radius of curvature between the inner sheath and the outer sheath. Forces are generated in directions deviating from each other, and the fixed portions of the two tend to peel off. In particular, if the fixing strength at the distal end portion of the bending portion of the endoscope subjected to the bending action is low, the distal end portion of the inner sheath is easily peeled off, and as a result, the distal end portion of the inner sheath may be exposed outside the distal end of the outer sheath. is there.

[0006] In the case of the high-frequency treatment instrument, there is a risk that the metal portion at the tip of the exposed inner sheath may burn a portion other than the target portion. further,
There is a disadvantage that the strength of fixing the inner sheath and the outer sheath gradually decreases due to the heat generated when performing the process using the high frequency, and the fixing portions of both of them are more easily detached.

In view of the above, the present invention has a simple structure, in particular, to prevent the inner sheath constituting the insertion portion of the treatment instrument from peeling off and displacing the outer tube covered by the inner sheath. An object of the present invention is to provide a treatment tool for an endoscope.

[0008]

An endoscope treatment tool according to the present invention comprises a flexible inner sheath made of a metal coil, which is covered with a tube by extruding a resin around the outer periphery of the inner sheath. The tube is tightly fixed to the outer periphery. Since the tube is tightly fixed and formed by extruding the synthetic resin on the outer periphery of the inner sheath in this manner, the tight fixing strength therebetween is increased, and pulling to the outer tube during use or tension during high-frequency current application is performed. The fixing portion between the two can be easily peeled off due to heat or the like, and the metal inner sheath can be prevented from being exposed due to the displacement between the two.

[0009]

1 and 2 show a first embodiment of the present invention. This embodiment relates to a high-frequency snare 1 for ablating a polyp with a high-frequency current, and the overall configuration thereof is shown in FIG. FIG. 1A shows a distal end portion of the insertion portion (sheath) 2, and FIG. 2B shows a hand side portion of the insertion portion 2.

As shown in FIG. 2, the high-frequency snare 1 includes a sheath-shaped insertion portion 2 and an operation portion 3 connected to the sheath-shaped insertion portion. Has become. The operation section 3 is detachable from the insertion section 2, and the wire section 4 is detachable from them.

As shown in FIG. 1, an insertion portion 2 of a high-frequency snare 1 is provided with a flexible inner sheath 5 made of a metal coil closely wound and a flexible resin tube (outer sheath) covered on the outer periphery thereof. Sheath 6). The tube 6 is formed over the entire length of the inner sheath 5 by being tightly fixed to the outer periphery of the inner sheath 5 by, for example, extruding an ethylene tetrafluoride resin. As shown in FIG. 2A, the outer peripheral surface of the inner sheath 5 that covers the tube 6 has a corrugated uneven shape due to a closely wound coil element wire 5a.
As described above, since the tube 6 is formed by extruding the resin on the outer peripheral surface of the inner sheath 5, the resin flows into the tube corresponding to the corrugated uneven outer peripheral surface, and the inner sheath 5 is formed. And the tube 6 are tightly fixed as a whole. Thus, not only the inner circumference of the tube 6 but also the outer circumference of the tube 6 has a substantially corrugated shape.

A connecting member 7 for detachably fixing the operation section 3 is adhesively fixed to the proximal end of the insertion section 2.
The proximal end of the insertion section 2 is inserted into a drill hole 8 coaxially drilled at the distal end of the connecting member 7 and is adhesively fixed.

The distal end of the tube 6 protrudes from the distal end of the inner sheath 5 by about 1 mm, and the inner and outer diameters of the protruding portion 9 are reduced so as to be smaller than the proximal end portion. For this reason, the insertion section 2 is not hooked when inserted into the forceps channel of the endoscope, and the tissue to be resected is less likely to come into contact with the inner sheath 5. Of course, the protrusion 9 is formed at the same time when the tube 5 is formed by tubing by extrusion.

On the other hand, the wire portion 4 has a snare wire 10 formed by cutting and bending a conductive wire in the middle.
And an operation wire 11 connected to the snare wire 10. The operation unit 3 includes an operation unit main body 12.
And a slider 1 that can move forward and backward with respect to the operation unit body 12.
3, the distal end of the operation section main body 12 is detachably connected to the proximal end of the insertion section 2, and the slider 13
Is detachably connected to the proximal end of the operation wire 11 via an operation pipe 14. Although not shown, the wire portion 4 is electrically connected to a high-frequency power supply via the slider 13 and a connection cord.

Next, the operation of the configuration of the first embodiment will be described. First, after the distal end portion of the endoscope is guided into the body cavity, the insertion portion 2 of the high-frequency snare 1 is introduced through the forceps channel of the endoscope, and the distal end portion of the insertion portion 2 is guided into the body cavity. During this operation, the slider 13
Is fully pulled toward the user, and therefore, the snare wire 10 is housed in the insertion portion 2 as shown in FIG.

Then, while observing the endoscope, the endoscope is operated to guide the tip of the high-frequency snare 1 near the polyp. Thereafter, when the slider 13 is pushed to the distal end side and the snare wire 10 of the wire portion 4 is pushed out from the distal end of the insertion portion 2, the snare wire 10 is opened while protruding from the distal end of the insertion portion 2 as shown in FIG.

After that, the operation of the endoscope and the operation of moving the high-frequency snare 1 forward and backward are combined, the snare wire 10 is hooked on the polyp, and then the slider 13 is pulled toward the hand.
The snare wire 10 is pulled into the insertion section 2 to bind the polyp. Thereafter, high frequency is supplied to the snare wire 10 from a high frequency power supply (not shown) to burn off the polyp.

In the structure of this embodiment, a resin tube 6 is formed on the outer peripheral surface of the inner sheath 5 by extrusion and covered, so that the inner sheath 5 and the tube 6 are tightly fixed over the entire length thereof. Sheath 5 and tube 6
Do not deviate from each other. That is, the distal end of the metal inner sheath 5 is not exposed outside from the distal end of the tube 6, so that the distal end of the metallic inner sheath 5 is
Is exposed to the outside from the tip, there is no risk of cauterizing at high frequency to normal tissue other than the target site.

Further, since the tube 6 is in close contact with the outer periphery of the inner sheath 5, the outer diameter of the insertion section 2 composed of both is minimized as much as possible, and the diameter of the insertion section 2 can be reduced. By reducing the diameter of the insertion section 2 in this way, the amount of insertion / removal force when the insertion section 2 is inserted into and removed from the forceps channel of the endoscope can be reduced. In addition, the outer tube 6
Since the outer peripheral surface of the forceps has a wavy shape, when the insertion portion 2 is inserted into the forceps channel, the contact area with the inner wall of the forceps channel is reduced, so that the sliding resistance is reduced and the amount of insertion / removal force is reduced. It is reduced.

Further, in the configuration of this embodiment, since the inner sheath 5 and the tube 6 are in close contact with each other over the entire length of the insertion section 2, even when the insertion section 2 is curved, Can be prevented by the tube 6 closely contacted from the outside. Accordingly, it is possible to suppress an increase in sliding resistance of the wire portion 4 with the operation wire 11 due to a displacement between the coil wires of the inner sheath 5. That is, the snare wire 10 can be always opened and closed with a stable and light force.

Further, since the squeezed portion of the projecting portion 9 of the tube 5 can be formed simultaneously with the extrusion of the other portions of the tube 6, the projecting portion 9 can be produced at low cost and its strength can be secured.

FIG. 3 shows a second embodiment of the present invention. This embodiment relates to a grasping forceps, and the insertion portion 2 has an inner sheath 5 made of a metal coil and an outer periphery of the inner sheath 5 made of, for example, ethylene tetrafluoride as in the first embodiment. And a tube 6 that is tightly fixed and covered by extruding the resin.

On the other hand, a grasping forceps portion 15 comprising two grasping arms 15a and 15b made of a metal elastic body is connected and fixed by brazing or the like via an operation wire 16 and a connection pipe 17, thereby forming a wire portion 18. doing. The wire portion 18 is inserted into the inner hole of the insertion portion 2 so as to be able to advance and retreat.

Further, a short cylindrical metal tip 19 is attached to the tip of the inner sheath 5. The tip 19 is provided between the two gripping arms 15 a and 15 b of the gripping forceps portion 15. , And when it is divided into two, a pin 20 is provided.

On the other hand, although not shown, the proximal end of the insertion section 2 is fixed to the operating section main body 12 having a cock capable of feeding liquid, and the proximal end of the wire section 18 is moved forward and backward with the operating section main body 12. The slider 13 is fixed to a free slider 13.

Next, the operation of the configuration of this embodiment will be described. The distal end of the grasping forceps is introduced into the body cavity through the channel of the endoscope introduced into the body cavity. On this occasion,
The slider 13 is pulled toward the hand side, and the two gripping arms 15a and 15b are drawn into the insertion section 2 and are in a closed state. And, under the observation of the endoscope,
By operating the endoscope, the distal end of the grasping forceps portion 15 is guided to the vicinity of a foreign substance in the body cavity. At this time, if the foreign substance is difficult to be confirmed by being covered with blood, mucus, or the like, the physiological substance is injected through the cock of the operation unit 3 to inject the foreign substance from the distal end opening of the insertion unit 2 and wash the foreign substance. Then, after confirming the foreign matter, the slider 13 is pushed to the distal end side, and the forceps portion 15 is protruded and opened more than the insertion portion 2.
Pull the slider 13 toward the hand while pressing the
The grasping arms 15a and 15b of the forceps unit 15 are closed to grasp the foreign matter. Thereafter, the patient is pulled out of the body together with the endoscope, and the foreign matter is collected.

According to this embodiment, similarly to the first embodiment, the outer tube 6 does not shift with respect to the inner sheath 5, so that the shift of the outer tube 6 causes a decrease in the liquid feeding ability and an endoscope. It is possible to prevent snagging at the time of insertion into a mirror. Further, the grasping forceps of this embodiment can also be used with a high-frequency treatment instrument, and in that case, the same effects as those of the first embodiment can be obtained.

FIG. 4 shows a third embodiment of the present invention. This embodiment is different from the first embodiment in that the cross-sectional shape of the closely wound metal coil wire 21a forming the inner sheath 21 is different. That is, the tightly wound end faces of the coil wires 22 are flat and closely adhered to each other, and the inner side surface 22a and the outer side
b is a concave shape that is depressed in an arc shape. The inner and outer peripheral surface portions of the inner sheath 21 are each formed in a wavy shape. The outer peripheral surface shape of the tube 23 formed by coating the outer peripheral surface of the inner sheath 21 over the entire length by extrusion molding is formed in a wavy shape according to the wavy shape of the outer peripheral surface portion of the inner sheath 21. Other configurations are the same as those of the first embodiment.

In this embodiment, the cross-sectional shape of the coil wire 22 of the inner sheath 21 has a drum-like shape in which the center is dented on both the inner and outer surfaces. Further, the shape of the outer peripheral surface of the tube 23 is also corrugated according to the shape of the outer peripheral surface of the inner sheath 21.

According to such a configuration, the area of contact with the inner wall of the forceps channel when inserted into the forceps channel of the endoscope is smaller than in the first embodiment, and the sliding resistance is further reduced. The amount of insertion / removal force is reduced. Further, even when the gap between the coil wires 22 is small and resin cannot flow in, the outer sheath closely adheres in a wave shape along the drum-shaped coil cross section. Displacement can be firmly prevented. Other effects are the same as those of the first embodiment.

The present invention is not limited to the above embodiments. For example, in each of the above-described embodiments, the resin tube is extruded over substantially the entire length of the inner sheath to form a coating. However, the extruded portion is extruded only at a particularly necessary distal end portion of the insertion portion. You may do so. The particularly required distal end portion varies depending on the use or the like used, but, for example, when a required amount of the distal end is protruded from the distal end of the forceps channel of the endoscope, from the distal end to the portion located in the curved portion of the endoscope. Is a range including at least the portion of

[0032]

As described above, according to the present invention, since the outer peripheral surface of the inner sheath is covered with the tube formed by extrusion molding, the inner sheath and the tube covering the outer peripheral surface thereof are firmly and tightly adhered. Therefore, the inner sheath and the tube covering the inner sheath do not shift. Thereby, for example, the distal end of the inner sheath is exposed from the distal end of the tube, and there is no fear of burning normal tissue other than the target portion.

In addition, since the outer tubes are formed in close contact with the inner sheath by extrusion molding, the outer diameters of those sheaths are small and the diameter can be reduced, so that the amount of operating force to be inserted into the endoscope can be reduced. . Further, since the outer peripheral surface of the outer tube usually has a wavy shape, the contact area with the inner wall of the forceps channel of the endoscope is small, and the sliding resistance can be further reduced. This also reduces the amount of insertion / removal force to the endoscope.

When a curve is applied, the displacement between the coil wires of the inner sheath can be prevented by a tube closely attached to the outer periphery thereof. Accordingly, it is possible to suppress an increase in sliding resistance with, for example, an operation wire that is inserted into the inner sheath so as to be able to advance and retreat freely due to a displacement between the coil wires of the inner sheath. Then, the treatment section such as the snare wire can always be operated with a stable and light force.

[Brief description of the drawings]

FIG. 1A is a cross-sectional view of a distal end portion of an insertion portion of a high-frequency snare according to a first embodiment of the present invention, and FIG. 1B is a cross-sectional view of a proximal end portion of the insertion portion of the high-frequency snare. FIG.

FIG. 2 is an external view showing the entire high-frequency snare according to the first embodiment of the present invention.

FIG. 3 is a sectional view of a distal end portion of a grasping forceps according to a second embodiment of the present invention.

FIG. 4 is a sectional view of a distal end portion of an insertion portion of a high-frequency snare according to a third embodiment of the present invention.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... High frequency snare, 2 ... insertion part, 4 ... wire part, 5 ... inner sheath, 5a ... coil wire, 6 ... tube, 10 ... snare wire, 15 ... gripping forceps part, 18 ... wire part, 21 ...
Inner sheath, 22: coil wire, 23: tube.

Claims (1)

(57) [Claims] 1. An outer periphery of a flexible sheath made of a metal coil,
An endoscope treatment tool having an insertion portion formed by covering a synthetic resin tube, wherein the synthetic resin is extruded and formed on the outer periphery of the sheath, whereby the tube is tightly fixed to the outer periphery of the sheath. A treatment tool for an endoscope, comprising: