JP3142477B2 - Endoscopic high-frequency incision device - 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 tool for endoscopically removing and collecting a tumor in a body cavity.

[0002]

2. Description of the Related Art In recent years, benign and malignant tumors such as polyps formed in the gastrointestinal tract of the body such as the esophagus, stomach and large intestine are often found early with the development of endoscopy. The number of cases in which polyps and tumors are removed and harvested endoscopically is also rapidly increasing. In particular, endoscopic polypectomy is being applied as a minimally invasive treatment,
Aging society, Westernization of dietary habits has spread rapidly along with the increase in cases of polyps and cancer.

Here, endoscopic polypectomy will be described. As shown in FIG. 4, an endoscope 13 for observing the inside of a body cavity, a high-frequency incision device for inserting the forceps hole 9 of the endoscope 13 to strangle and resect the lesion 8, and a high-frequency power supply device 12
From the high-frequency power supply device 12 to the earth counter electrode 1
1 is brought into contact with a part of the body such as a foot, and the other is connected to a snare wire 1 of a high-frequency incision tool, and high-frequency current is applied to burn off the tissue at the portion in contact with the snare wire 1. To explain the high-frequency incision tool further, a snare wire 1 having a loop-shaped tip inside a sheath tube 2 serving as an outer cylinder is described.
And a rear-end operating section 5 for operating so that the tip of the snare wire can be taken in and out of the sheath tube,
The snare wire 1 is hooked on a lesion 8 such as a polyp, the snare wire 1 is pulled into a sheath tube, the lesion 8 is strangled, and a high-frequency current is applied to the snare wire 1 to burn off the lesion. Will be

[0004] The resected lesion is inserted by inserting a recovery forceps 14 as shown in FIG. 5 through the forceps hole 9 of the endoscope 13, grasping the lesion, and pulling the entire endoscope out of the body to take out the lesion. afterwards,
The pathology is the most important information for determining future treatment policies, such as judging whether the lesion is malignant or benign or determining the depth of cancer lesions. However, when the resected lesion is gripped by the recovery forceps 14, in the endoscope 13 provided with a one-channel forceps hole, the snare used for the resection must be removed from the forceps hole once and replaced with the recovery forceps 14. This is time-consuming and time-consuming for the surgeon.

At times, the lesion may move and be lost due to the respiratory movement or the like while the snare is replaced with the recovery forceps 14. Especially in the large intestine, it is difficult to find the resected lesion due to unevenness of the digestive tract, and the operability of the endoscope is lower than that of the upper digestive tract, so it can not be collected, making pathological examination impossible. is there. In addition, depending on the size of the lesion, it is not possible to take it at once, and it is often divided into two parts and collected, and in many cases there are multiple polyps,
Since the collection is repeated, the burden on the operator, the treatment time is prolonged, and the burden on the patient is increased. On the other hand, if the forceps hole is a two-channel endoscope, one can be used by inserting a snare on one side and a recovery forceps on the other side. However, since the pain of the patient at the time of insertion increases and the price is expensive, it is not widely used in general hospitals.

[0006]

DISCLOSURE OF THE INVENTION The present invention has been made as a result of various studies in order to solve the problems that the resected lesion in conventional endoscopic resection of a polyp or the like cannot be recovered immediately and that it takes a long time for treatment. It is an object of the present invention to provide an endoscopic high-frequency incision device for easily and reliably removing and collecting lesions such as polyps.

[0007]

SUMMARY OF THE INVENTION In a high-frequency incision device for endoscopically resecting a lesion such as a polyp generated in a tissue in a body cavity, a distal end is passed through a wire portion having a snare wire, a sheath tube, and a sheath tube. A high-frequency incision device comprising a rear-end operating portion for moving a distal-side snare wire forward and backward to be accommodated in a sheath tube, wherein one or more wires are provided on a loop of the distal-side snare wire,
The snare wire and the wire are connected at one or more locations by a movable connecting portion, and a stopper portion for consolidating the loop is provided at the root of the loop.

Further, at least one or more wires are provided on the dome at the snare tip snare wire loop base and the opposite side thereof, or at least one snare wire snare wire loop base and at the opposite side thereof. An endoscope-like high-frequency incision device characterized in that the above-mentioned wires are arranged in a dome shape and the wires are fixed or slidably fixed to a snare wire so as to cross the wires.

[0009]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A schematic view and a sectional view of an endoscopic high-frequency incision device according to the present invention are shown in FIGS. In any case, the high-frequency incision tool for removing a lesion has the same structure as a conventional high-frequency incision tool, and an auxiliary tool for recovery is provided.

FIG. 1 shows that one or more insulative wires 3 are arranged in a loop on the loop of the snare wire 1 so that the gap between the snare wires is maintained and the wire 3 is positioned on the snare wire circle. A movable connecting portion 4 is provided, and a stopper 6 for strangling the wire 3 and grasping a lesion is provided. All the distal ends enter the sheath tube 2 and once come out of the sheath tube 2, the stopper 6 and the connecting portion 4 move to the distal end side of the snare wire 1 using the distal end of the sheath tube as a guide, and at the same time, the loop diameter becomes small, and the lesion that has been cut off Is held by the connecting portion 4 and the stopper 6 on the loop.

FIG. 2 shows a snare wire having a stopper 6 at the root of a loop at the tip of the snare wire, and at least two wires 3 fixed to the tip of the snare wire on the opposite side from the stopper 6, and the snare wire 1 is housed in a sheath tube. In this case, the stopper 6 is stored in the sheath tube,
Alternatively, as shown in FIG. 2B, the endoscope 13 is set along the outer side of the sheath tube 2 with a stopper 6 having an outer diameter that can be inserted into the forceps hole of the endoscope 13. When the snare wire 1 is taken out of the sheath tube 2 and the snare wire 1 is pulled into the sheath tube, the tip of the sheath tube serves as a guide, the stopper 6 moves to the tip, and the resected lesion is grasped by the wire 3.

FIG. 3 further shows a horizontal wire 3 ′ connected to the snare wire 1 so as to cross the vertical wire 3. The horizontal wire 3 ′ is movably fixed to the snare wire 1, and the sheath tube 2. When the snare wire 1 is stored in the sheath tube, all of the snare wire is stored in the sheath tube.
When is exited from the sheath tube 2, the stopper 6 is guided by the distal end of the sheath, moves to the distal end of the snare wire 1, and the lesion cut in the bag-shaped wire is gripped. At this time, it is preferable that the crossing portion of the vertical wire 3 and the horizontal wire 3 ′ be connected so as to be fixed or movable so that the shape of the wire can be maintained by taking in and out the snare, and it is not necessary to fix the wire.

Next, the material will be described. The material other than the snare wire is not particularly limited as long as it is a material having an insulating property or a coated insulator and generates heat due to high frequency and has heat resistance. To further explain, the sheath tube 2 slides well between the snare wire 1 and the forceps hole of the endoscope 13, and the distal end is operated by turning or changing the direction of the tube or by remote control.
Rigid polyvinyl chloride resin, fluorocarbon resin, polyethylene resin, and polypropylene resin are suitable, but such a resin or other resin may be a composite tube of a metal coil or mesh, etc. in order to impart rigidity. Is not done.

The wire at the tip has an outer diameter of 0.1 to 1.0 that can be stored together with the snare wire 1 in the sheath tube.
mm or a single rope or mini-rope, nylon or fluorine-based plastic or metal wire coated with an insulator, or silk or other fiber is suitable, but the loop shape has good resilience and does not bend or bend. If there is, there is no particular limitation. It is necessary that the stopper 6 be capable of consolidating the wires and that the stopper 6 should not be loosened when gripping the lesion. Examples of the stopper 6 include resins such as polyvinyl chloride resin and urethane resin, and rubbers such as natural rubber, silicone rubber, and isoprene rubber. However, there is no particular limitation.

On the other hand, the snare wire 1 is a conductive material through which a high-frequency current can flow, and has a diameter of 1 when the loop is opened.
It is the same size as a commonly used snare of 0 to 35 mm, and has an outer diameter of 0.2 to access the sheath tube.
A single wire or mini-rope is preferable with a stainless steel wire of ~ 1.0 mm, but it has a certain degree of rigidity such as restoring ability to maintain the loop shape of the snare and operability of the wire by remote control, and it comes in contact with bodily fluid in the body cavity. However, the material is not particularly limited as long as it is hard to rust and hard to affect the body.

[0016]

EFFECT OF THE INVENTION Regarding recovery after resection of a lesion, which was a problem with the conventional high-frequency incision device, the use of the high-frequency incision device of the present invention enables the resection and recovery of the lesion without impairing the operability of the conventional high-frequency incision device. Simultaneous removal of polyps and the like was facilitated. In particular, since the lesion can be reliably collected, it becomes valuable data on a future treatment policy by a pathological examination or the like.

[Brief description of the drawings]

FIG. 1 is a general view showing a high-frequency incision tool used in the present invention, wherein a shows a state in which a snare wire is opened, and b shows a state in which a lesion is cut.

FIG. 2 is an overall view showing a high-frequency incision tool used in the present invention, wherein a shows a state in which a snare wire is opened, b shows an example in which the snare wire is stored, and c shows a state where a lesion is resected. FIG.

FIG. 3 is a general view showing a high-frequency incision tool used in the present invention, wherein a shows a state in which a snare wire is opened, and b shows a state in which a lesion is resected.

FIG. 4 is a diagram showing a use state of the high-frequency incision tool.

FIG. 5 is a view showing a collection forceps.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Snare wire 2 Sheath tube 3 Wire 4 Connection part 5 Rear end operation part 6 Stopper 7 Connection cord 8 Lesion 9 Forceps hole 10 Body 11 Counter electrode 12 High frequency power supply 13 Endoscope 14 Collection forceps

Continuation of the front page (58) Field surveyed (Int. Cl. ⁷ , DB name) A61B 17/22 A61B 18/00-18/28

Claims (3)

(57) [Claims] 1. A high-frequency incision device for endoscopically resecting a lesion, such as a polyp, generated in a tissue in a body cavity, wherein the distal end is passed through a wire portion made of a snare wire, a sheath tube, and a sheath tube, and the distal end portion is passed through a sheath portion. What is claimed is: 1. A high-frequency incision device comprising a rear end operating portion for advancing and retracting a snare wire and storing the snare wire in a sheath tube, wherein one or more wires are attached on a loop of the tip snare wire, and the snare wire and the wire are movably connected. An endoscope-like high-frequency incision tool characterized in that the end portion of the loop is connected at one or more locations, and a stopper portion for consolidating the loop is provided at the root of the loop. 2. The endoscopic high-frequency incision device according to claim 1, wherein at least two or more wires are provided in a dome shape on the loop root of the snare wire at the tip of the snare tube and on the opposite side. 3. The snare tube according to claim 1, wherein at least two or more wires are arranged in a dome shape at the tip of the snare wire and opposite to the loop root of the snare wire, and at least two wires are attached to the snare wire so as to cross the wires. Item 2. An endoscopic high-frequency incision according to Item 1.