JP3323013B2 - Endoscopic treatment device for ligation treatment of varicose veins and other aneurysms - 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 device for an endoscope, which is attached to a distal end portion of an endoscope and ligates and treats an varicose vein or other varicose vein in a body cavity. .

[0002]

2. Description of the Related Art Conventionally, as a treatment tool for an endoscope of this type, a treatment tool disclosed in U.S. Pat. No. 4,735,194 is known. The treatment instrument for an endoscope includes an outer cylinder mounted on a distal end portion of the endoscope. An inner cylinder is inserted inside the outer cylinder so as to be movable in the axial direction. One end of a wire is connected to the inner cylinder, and the other end of the wire extends to the outside through the forceps channel of the endoscope and is connected to the operation handle. By pulling the operation handle, the inner cylinder moves rearward. An O-ring made of an elastic member is mounted on the outer peripheral portion of the inner cylinder protruding from the front end of the outer cylinder in a state expanded in the radial direction.

In this state, an endoscope is inserted into the esophagus, for example, and the distal end of the inner cylinder is placed on the varicose vein to be treated. Then, when the operation handle is pulled to move the inner cylinder backward, the O-ring is pushed out to the distal end edge of the outer cylinder and falls off from the inner cylinder to ligate the base of the varicose vein. The ligated varicose vein is impaired in blood circulation and hardens, falls off, and the treatment is completed.

However, in such an endoscope treatment tool, since only one O-ring is mounted on the inner cylinder, the endoscope must be moved outside the body cavity each time ligation treatment of a plurality of varicose veins is performed. , The inner cylinder to which the O-ring is attached must be replaced, and inserted again into the body cavity to perform the treatment. For this reason, when performing ligation treatment for a plurality of varicose veins, the endoscope must be taken in and out of the body cavity by the number of varicose veins, causing considerable pain to the patient.

[0005]

SUMMARY OF THE INVENTION The present invention has been made to solve such inconvenience, and it has been made possible to perform a ligation treatment a plurality of times with an endoscope inserted into a body cavity. It is an object of the present invention to provide a treatment tool for an endoscope for ligating and treating a varicose vein or other affected area, which can reduce the pain given to the patient.

[0006]

SUMMARY OF THE INVENTION In order to achieve the above object, the present invention provides an outer cylinder in which a distal end of an endoscope is mounted on a rear end, and an endoscope which is movable in an axial direction inside the outer cylinder. An inner cylinder inserted into the inner cylinder, a spring for urging the inner cylinder toward the front when the inner cylinder moves rearward, and a tip portion connected to the inner cylinder, from the inner cylinder to the outer cylinder A wire extending rearward through the interior of the mounted endoscope to the outside, and moving the inner cylinder rearward against the urging force of the spring by pulling the rear end from the outside; A plurality of ring-shaped elastic members mounted at predetermined intervals in the axial direction of the inner cylinder in a state of being elastically expanded in the radial direction on the outer peripheral portion of the inner cylinder protruding from the front end of the outer cylinder; A plurality of arms extending forward from the outer cylinder and arranged around the outer circumference of the inner cylinder at predetermined intervals in a circumferential direction of the inner cylinder; It is to become a plurality of claw portions which are respectively disposed behind each ring-like elastic member, the outer
The tube extends along each arm located between each arm
A plurality of loose pieces are provided integrally with the outer cylinder,
The arm is stored between each of the loose pieces adjacent to the
A substantially cylindrical shape is formed by the outer surface and the outer surface of each arm.
A pressing surface that pushes the ring-shaped elastic member forward when the inner cylinder moves rearward and the claw contacts the front ring-shaped elastic member is provided on a front surface of each of the claw portions. Formation
In addition, on the rear surface of each of the claws , the arms are radially expanded when the inner cylinder moves forward and the claws come into contact with the ring-shaped elastic member at the rear. An inclined surface that passes over the ring-shaped elastic member is formed , and the ring-shaped elastic member is pushed forward by the pressing surface of each of the claw portions disposed at the forefront, thereby causing the ring-shaped elastic member to move into the inner cylinder. It is characterized by being made to fall off from.

[0007]

In the present invention, it is preferable to provide a guide member which is inserted into the outer cylinder and guides the axial movement of the inner cylinder.

Also, behind the mounting portion of the ring-shaped elastic member of the inner cylinder, the ring is moved when the inner cylinder moves forward and the inclined surface of the claw contacts the ring-shaped elastic member. It is preferable that a locking portion for preventing the elastic member from moving backward is formed.

It is preferable that the outer cylinder is provided with a locking portion for locking the inner cylinder when the inner cylinder moves to the frontmost position and preventing the inner cylinder from moving in the same direction.

[0011]

[0012] Also, before Symbol elastic ring member is preferably a rubber O-ring.

[0013]

[Action] using endoscopic treatment tool of the present invention to ligate treating nodular affected part such as a plurality of varices, first, attached to the distal end of the endoscope rear end portion of the outer tube In this state, the endoscope is inserted into the body cavity, and the affected part to be treated is covered with the front end of the inner cylinder.
Next, the affected part is sucked into the inner cylinder through the inner cylinder. Then, in a state where the affected part is pulled into the inside of the inner cylinder, when the wire is pulled against the urging force of the urging means and the inner cylinder is moved backward, each ring-shaped elastic member attached to the inner cylinder is Each of the ring-shaped elastic members pushed out by the pressing surface of the claw portion disposed at the foremost comes into contact with the pressing surface of the claw portion disposed rearward, and falls off from the inner cylinder. The base of the affected part is ligated by the dropped ring-shaped elastic member, and the first ligation treatment is completed.

After the completion, when the wire is loosened, the inner cylinder is moved forward by the urging force of the urging means, and the ring-shaped elastic member located behind the claw contacts the inclined surface of the claw. At this time, the biasing force of the biasing means acts on the inclined surface via the ring-shaped elastic member, and the biasing force pushes the inclined surface radially outward. As a result, the arm part is expanded in the radial direction, the claw part gets over the ring-shaped elastic member, and the inner cylinder returns to the original position.

Thereafter, the same operation as the first time is performed by the number of ring-shaped elastic members mounted on the inner cylinder, and the ligation treatment of the affected part corresponding to the number is performed.

In this case, the outer cylinder is provided with a plurality of loose pieces, and the arms are housed between the adjacent loose pieces, so that the outer surface of the distal end of the treatment tool for an endoscope can be made uneven. And smooth insertion into the body cavity.

Further, by inserting the guide member into the outer cylinder, even if a bias of the pulling force with respect to the inner cylinder occurs when a wire is pulled, the guide member moves the inner cylinder in the axial direction. To prevent the inner cylinder from tilting.

Further, a locking portion is formed behind the insertion portion of the ring-shaped elastic member of the inner cylinder, and the inner cylinder moves forward so that the inclined surface of the claw portion contacts the ring-shaped elastic member. When the rearward movement of the ring-shaped elastic member is prevented when the ring-shaped elastic member comes into contact, the operation of the claw portion over the ring-shaped elastic member is reliably performed.

Further, when the outer cylinder is provided with a locking portion which locks to the inner cylinder when the inner cylinder moves forward most to prevent the inner cylinder from moving in the same direction, Inadvertent dropping from the outer cylinder is prevented.

[0020]

[0021]

[0022] Also, before Symbol elastic ring member, in the case of rubber O-rings, it is possible to improve the durability against a temperature change when subjected to heat sterilization treatment.

[0023]

DESCRIPTION OF THE PREFERRED EMBODIMENTS One embodiment of the present invention will be described below with reference to the drawings. FIG. 1 is an explanatory sectional view of a treatment tool for an endoscope according to the present embodiment .
FIG . 2 is an exploded perspective view of the endoscope treatment tool shown in FIG.
FIG . 3 and FIG. 3 are explanatory perspective views of a part of the distal end portion of the treatment tool . In the present embodiment, a treatment tool capable of performing ligation treatment three times while the endoscope is inserted into a body cavity is taken as an example.

[0024]

[0025]

[0026]

[0027]

[0028]

[0029]

[0030]

[0031]

[0032]

[0033]

[0034]

[0035]

[0036]

[0037]

The treatment tool for an endoscope of this embodiment is shown in FIG.
As described above, the outer cylinder 35, the guide member 36 attached to and fixed to the rear end of the outer cylinder 35, and the inner member that is movably inserted in the axial direction while protruding from the front end of the outer cylinder 35. And a cylinder 3. Inside the outer cylinder 35, the inner cylinder 3
A coil spring 4 is provided for urging the inner cylinder 3 forward when is moved rearward. One end of a wire 5 is connected to the inner cylinder 3, and the other end of the wire 5 extends to the outside through the forceps channel of the endoscope. By pulling the wire 5, the inner cylinder 3 moves rearward against the urging force of the coil spring 4. Three O-rings 7a to 7c are provided on the outer peripheral portion of the inner cylinder 3 protruding from the front end of the outer cylinder 35.
Are mounted at equal intervals in the axial direction while being elastically expanded in the radial direction. On the outer peripheral portion of the inner cylinder 3, four arm portions 8 extending forward from the outer cylinder 35 are arranged at equal intervals in the circumferential direction. The arm portion 8 is provided with claw portions 9a to 9b which are respectively arranged behind the O-rings 7a to 7c and individually contact the O-rings 7a to 7c when the inner cylinder 3 moves in the front-rear direction. . As shown in FIG. 2 , four loose pieces 37 extending forward from the outer cylinder 2 are arranged at equal intervals in the circumferential direction between the arms 8.

Hereinafter, each component will be described in detail.

The outer cylinder 35 is formed in a cylindrical shape using a relatively hard synthetic resin having excellent transparency such as an ABS resin, a polycarbonate resin, a styrene resin, and a polyvinyl chloride resin. The outer cylinder 35 has a rear end inside the outer cylinder 3.
A cylindrical guide member 36 exposed from 5 is inserted and fixed. As shown in FIG. 1 , the guide member 36 has a small-diameter portion 38 having a different outer diameter from the front end to the rear end.
A middle diameter portion 39 and a large diameter portion 40 are sequentially formed. FIG.
As shown in FIG. 7, the guide member 36 has a projection 41 formed on the outside of the rear end thereof, and the projection 41 is locked by a locking groove 42 formed on the rear end of the outer cylinder 35. The guide member 36 is integrally connected to the outer cylinder 35. Also,
A distal end of an endoscope (not shown) is attached to a rear end of the guide member 36. As shown in FIG. 2, each arm 8 is stored between adjacent loose pieces 37 of the outer cylinder 35, and the whole is formed by the outer surface of each loose piece 37 and the outer surface of each arm 8. It is formed in a substantially cylindrical shape. Thereby, the outer surface of the distal end portion of the treatment instrument for an endoscope is protected by the loose piece 37, and the unevenness of the outer circumference of the loose piece 37 and the arm 8 is reduced, so that the insertion into the body cavity can be performed smoothly. Can be.

As shown in FIGS. 1 and 2, the inner cylinder 3 is made of ABS resin, polycarbonate resin,
It is formed into a cylindrical shape using a relatively hard and highly transparent synthetic resin such as a styrene resin or a polyvinyl chloride resin, and is formed in a state of protruding from the front end of the outer cylinder 35. It is inserted movably in the axial direction between the inner wall and the outer wall of the small diameter portion 38 of the guide member 36. A short large-diameter portion 15 is formed at the rear end of the inner cylinder 3.
The coil spring 4 abuts the large-diameter portion 15 and the stepped portion 43 at both ends of the outer cylinder 35 between the medium-diameter portion 39 and the large-diameter portion 40 at the boundary between the large-diameter portion 39 and the large-diameter portion 40. It is provided in a state where it is made to be.

FIG. 1 shows the vicinity of the inner peripheral portion of the large diameter portion 15 .
Thus, the wire connecting portion 44 is formed, and one end of the wire 5 is detachably connected to the connecting portion 44. When the other end of the wire 5 is pulled, the inner cylinder 3 moves backward in the outer cylinder 35 against the urging force of the coil spring 4, and when the wire 5 is loosened, the inner cylinder 3 is pushed by the urging force of the coil spring 4. It moves forward and returns to its original state. When the inner cylinder 3 moves backward, the large-diameter portion 15
Abuts on the step 45 at the boundary between the small diameter portion 38 and the middle diameter portion 39 of the guide member 36, and further movement is prevented. A notch 46 is formed in the small diameter portion 38 of the guide member 36 in order to avoid interference with the wire connecting portion 44 when the inner cylinder 3 moves backward. The small-diameter portion 38 of the guide member 36 movably sandwiches and supports the inner cylinder 3 with the outer cylinder 35,
When a biased tension is transmitted to the inner cylinder 3 via the wire connecting portion 44, the inner cylinder 3 acts as a guide portion for preventing the inclination of the inner cylinder 3 and guiding the inner cylinder 3 to move linearly. .

The outer peripheral portion of the inner cylinder 3 is provided when the inner cylinder 3 moves.
A slide in which the claws 9a to 9c provided on the arm 8 slide.
The id groove 19 extends in the axial direction. The sly
The groove 19 is, as shown in FIG.
3 are formed at four locations at equal intervals in the circumferential direction. Also,
Three O-rings are provided on the outer peripheral portion of the cylinder 3 protruding from the outer cylinder 2.
In the axial direction in a state in which the
Are mounted at equal intervals. The O-rings 7a to 7c
Compounding a reinforcing agent such as carbon with natural rubber or natural rubber
Or molded with synthetic rubber, etc.
By adopting rubber O-rings 7a to 7c as
Resistance to temperature changes during heat sterilization
It is excellent and maintains elastic force and prevents deterioration well.
Done. Also, as shown in FIG. 1, the claw portions 9a to 9c
On each front surface, when the inner cylinder 3 moves backward, each claw portion 9a
To the front O-rings 7a to 7c of
The pressing surface 23 for pushing each O-ring 7a to 7c forward is shaped.
Has been established. Although not shown in detail,
O-ring 7a pushed out by pressing surface 23 of one claw portion 9a
Is dropped from the inner cylinder 3 and the pressing surface 23 of the other claw portions 9b, 9c
The O-rings 7b and 7c pushed out by the
Move. On the other hand, an inner cylinder 3 is provided on each rear surface of the claw portions 9a and 9b.
When moving forward and abutting on the rear O-rings 7b and 7c
The arms 8 are expanded in the radial direction, and the O-rings 7b and 7c are
An inclined surface 24 that gets over is formed.

In order to treat a plurality of varicose veins using such a treatment tool, an endoscope is first inserted into a body cavity (not shown). At this time, as shown in FIG. 1, since each arm portion 8 is housed between each free piece portion 37, smooth insertion can be performed. Next, after the front end of the inner cylinder 3 is brought into contact with the varicose vein to be treated, the varicose vein is held in a state of being sucked into the inner cylinder 3 by a suction unit (not shown). As a result, the varicose vein is drawn into the inner cylinder 3, and the root thereof is located at the tip of the inner cylinder 3. Subsequently, the wire 5 is pulled to move the inner cylinder 3 backward against the urging force of the coil spring 4. At this time, FIG.
As shown in (2), the rear end of the inner cylinder 3 moves while being sandwiched between the small-diameter portion 38 of the guide member 36 and the outer cylinder 35. Therefore, the inner cylinder 3 moves without tilting, and shifts from the affected part. Accurate work can be performed by reliably preventing. Then, the O-ring 7a pushed out by the pressing surface 23 of the foremost claw portion 9a falls off from the inner cylinder 3, and the base of the varicose vein is ligated, and the first ligation treatment is completed.

Next, when the wire 5 is loosened, the inner cylinder 3 moves forward by the urging force of the coil spring 4, and as described above,
The arm 8 is expanded in the radial direction so that the claws 9a and 9b get over the O-rings 7b and 7c.
O-rings 7b and 7c are arranged in front of b, respectively.

Thereafter, by moving the endoscope to another varicose vein and performing the same operation as in the first time, the two varicose veins remaining with the endoscope inserted into the body cavity are respectively O-rings. 7b, to all completion of treatment is ligated by 7c
You.

[0047]

[0048]

[0049]

[0050]

[0051]

[0052]

[0053]

As is clear from the above description, the present invention
According to the method , the ligation treatment can be performed a plurality of times while the endoscope is inserted into the body cavity, so that the pain conventionally given to the patient can be remarkably reduced.

Further, in the present invention, a plurality of loose pieces are provided on the outer cylinder, and an arm is provided between the adjacent free pieces.
By storing the arms, the arms positioned in a protruding state on the outer periphery of the inner cylinder are housed between the respective free pieces adjacent to each other, and the outer surface of the distal end portion of the treatment tool for an endoscope has less irregularities, so that the body cavity Insertion into the inside can be performed smoothly.

In addition, since the guide member is inserted into the outer cylinder, even if a pulling force is imbalanced with respect to the inner cylinder when a wire is pulled, the guide member moves the inner cylinder in the axial direction. Therefore, stable ligation treatment of the affected part can be performed without tilting the inner cylinder.

Further, a locking portion is formed behind the insertion portion of the ring-shaped elastic member of the inner cylinder to suppress the movement of the ring-shaped elastic member rearward from the locking portion. Since the operation of getting over the ring-shaped elastic member can be reliably performed, the reliability of the treatment tool can be improved.

Further, the outer cylinder is provided with a locking portion which locks to the inner cylinder when the inner cylinder moves forward to prevent the inner cylinder from moving in the same direction. Can be satisfactorily prevented from falling off the outer cylinder.

[0058]

In the present invention, if the ring-shaped elastic member is a rubber O-ring, it is possible to improve the durability against a temperature change during the heat sterilization treatment. Can be maintained to prevent deterioration.

[Brief description of the drawings]

FIG. 1 is an explanatory view of an endoscope treatment tool according to an embodiment of the present invention .
Area view .

FIG. 2 is an explanatory exploded perspective view of the endoscope treatment tool shown in FIG . 1;
FIG .

FIG. 3 is an explanatory perspective view of a part of a distal end portion of the treatment tool for an endoscope .
FIG .

[Description of Signs] 35 ... outer cylinder , 3 ... inner cylinder , 4 ... coil spring , 5 ... wire ,
7a to 7c : O-ring , 8: Arm, 9a to 9c: Claw,
23 ... pressing surface, 24 ... inclined surface, 36 ... guide member, 37 ...
Free pieces.

──────────────────────────────────────────────────続 き Continued on the front page (58) Field surveyed (Int. Cl. ⁷ , DB name) A61B 17/12 A61B 1/00 334

Claims (5)

(57) [Claims] 1. An outer tube having a distal end mounted on a rear end of an endoscope, an inner cylinder inserted axially movably into the outer cylinder, and the inner cylinder moving rearward. A spring for urging the inner cylinder toward the front, a front end connected to the inner cylinder, and a rear end extending from the inner cylinder to the outside through an endoscope mounted on the outer cylinder. Is extended, and a wire that moves the inner cylinder rearward against the urging force of the spring by pulling the rear end from the outside, and an outer periphery of the inner cylinder protruding from a front end of the outer cylinder A plurality of ring-shaped elastic members mounted at predetermined intervals in the axial direction of the inner cylinder in a state where the inner cylinder is elastically expanded in the radial direction, and an outer peripheral portion of the inner cylinder extending forward from the outer cylinder and extending forward from the outer cylinder They are arranged and a plurality of arm portions in the circumferential direction of the inner cylinder disposed at a predetermined interval, provided the arm portion to the rear of each ring-shaped elastic member It and a plurality of claw portions, the outer cylinder, extending along each arm portion is located between the arms
Are provided integrally with the outer cylinder.
The arms are stored between the loose pieces adjacent to each other,
A generally cylindrical shape with the outer surface of the separating part and the outer surface of each arm
It is formed on, wherein the front of each claw portions, the inner cylinder is moved rearward pawl
A pressing surface is formed that pushes the ring-shaped elastic member forward when the portion contacts the front ring-shaped elastic member .
At the same time, on the rear surface of each claw portion, when the inner cylinder moves forward and the claw portion abuts on the rear ring-shaped elastic member, the arm portion is radially expanded to form the ring-shaped portion. An inclined surface that passes over the elastic member is formed , and the ring-shaped elastic member is dropped from the inner cylinder by pushing the ring-shaped elastic member forward with a pressing surface of each of the claw portions disposed at the forefront. An endoscope treatment tool for ligating and treating an varicose vein or the like affected part, characterized by having the above-mentioned configuration. 2. A is inserted into the outer cylinder, characterized in that a guide member for guiding the axial movement of the inner cylinder 請
An endoscopic treatment tool for ligating a varicose vein such as the varicose vein according to claim 1 . 3. The rear portion of the ring-shaped elastic member of the inner cylinder is provided behind the mounting portion of the ring-shaped elastic member when the inner cylinder moves forward and the inclined surface of the claw contacts the ring-shaped elastic member. 3. A treatment for an endoscope for ligating a varicose vein or the like affected part according to claim 1 or 2, wherein a locking part for preventing the backward movement of the elastic member is formed. Utensils. The method according to claim 4, wherein the outer cylinder, the locking portion to prevent movement in the same direction of the inner cylinder engages the inner cylinder when said inner cylinder is moved to the most forward is provided Claims characterized by the following :
An endoscopic treatment tool for ligating and treating an aneurysm-like diseased part such as the varicose vein according to any one of claims 1 to 3 . Wherein said ring-like elastic member, for ligating treating nodular diseased varicose veins, etc. according to any one of claims 1 to 4, characterized in that a rubber O-ring Endoscope treatment tool.