JP3967560B2 - Bipolar high-frequency treatment instrument for endoscope - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a bipolar high-frequency treatment instrument for an endoscope which has both positive and negative electrodes at a distal end portion and is used through a treatment instrument insertion channel of an endoscope.
[0002]
[Prior art]
In general, a high-frequency treatment instrument for an endoscope has an electrode attached to the tip of a conductive operation wire connected to one pole of a high-frequency power supply, and the other pole of the high-frequency power supply is placed in contact with the patient's body surface. A counter electrode is connected.
[0003]
However, in such a monopolar type high-frequency treatment tool, a high-frequency current flows using the patient's body as a conductor, and thus a tissue portion that does not require coagulation may be cauterized.
[0004]
Therefore, it is better in terms of energy efficiency and safety to use a bipolar high-frequency treatment instrument having both positive and negative electrodes provided at the distal end. Generally, a pair of opening and closing members that are opened and closed by remote operation from the proximal end side. In each of the tip portions, electrodes made of conductive members are arranged so as to be electrically insulated from each other.
[0005]
[Problems to be solved by the invention]
In such an endoscopic bipolar high-frequency treatment instrument, current is applied with a tissue sandwiched between a pair of electrodes, so that the opposing surfaces of both electrodes are exposed.
[0006]
Therefore, for example, when the tissue piece sandwiched between both electrodes is very small and the tissue piece collapses by applying a high-frequency current, both electrodes are in contact with each other and shorted, A high-frequency high current may flow, causing an accident or failure. Moreover, such a possibility may occur due to an erroneous operation or the like.
[0007]
Accordingly, an object of the present invention is to provide a highly safe bipolar high-frequency treatment instrument for an endoscope in which both electrodes are not short-circuited even in a poorly used state or when there is an erroneous operation.
[0008]
[Means for Solving the Problems]
In order to achieve the above object, the bipolar high-frequency treatment instrument for endoscope of the present invention has electrodes made of conductive members at the distal end portions of a pair of opening and closing members that are opened and closed by remote operation from the proximal end side. In the endoscopic bipolar high-frequency treatment instrument arranged in an electrically insulated state, the opposing surfaces of the pair of electrodes are formed so as to be exposed, and the pair is opened when the opening / closing member is fully closed. An interelectrode insulation securing member made of an electrical insulating material that prevents the electrodes from contacting each other is provided.
[0009]
The interelectrode insulation ensuring member may protrude from the base end side between the pair of opening / closing members, or the interelectrode insulation ensuring member may be one or both of the pair of opening / closing members, or a pair. It may be formed on one or both of the electrodes.
[0010]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described with reference to the drawings.
1 and 2 show a distal end portion of a bipolar high-frequency treatment instrument for an endoscope according to a first embodiment of the present invention. FIG. 1 shows a pair of elastic opening / closing members 2 in the distal end of a flexible sheath 7. FIG. 2 shows a state in which the pair of elastic opening / closing members 2 protrudes forward from the distal end of the flexible sheath 7 and is opened.
[0011]
The flexible sheath 7 to be inserted into and removed from the treatment instrument insertion channel of the endoscope is formed by an electrically insulating tube such as a tetrafluoroethylene resin tube, and each elastic opening / closing member 2 has good conductivity. It is formed of a leaf spring material. However, the elastic opening / closing member 2 may be a linear spring material or the like.
[0012]
An electrode 1 made of a conductive material fixed in an electrically conductive state with the elastic opening / closing member 2 is fixed to the tip of each elastic opening / closing member 2 with at least the surface of the opposing surface exposed.
[0013]
The pair of elastic opening / closing members 2 are arranged in a state of gradually expanding toward the front side in a natural state so that the elastic opening / closing members 2 can be elastically deformed and constricted so that the surface of each elastic opening / closing member 2 is not exposed. Is provided with an electrical insulation coating 2a.
[0014]
In the flexible sheath 7, an electrically insulating cylindrical flexible shaft 5 made of, for example, a tetrafluoroethylene resin tube is inserted and disposed over the entire length so as to advance and retract in the axial direction.
[0015]
A pair of conductive wires 3 are inserted and disposed along the entire length of the cylindrical flexible shaft 5, and one of the conductive wires 3 is provided with an electrically insulating coating 3 a over the entire length. Therefore, the pair of conductive wires 3 are electrically completely insulated.
[0016]
An insulating chip 6 made of an electrically insulating hard plastic or the like is fixed to the distal end of the cylindrical flexible shaft 5, and the base ends of the pair of elastic opening / closing members 2 are connected and fixed to the insulating chip 6.
[0017]
FIG. 3 shows a cross section of the portion (III-III cross section in FIG. 1), and the pair of elastic opening and closing members 2 are fixed in a state of sandwiching the insulating chip 6, so that the gap between each other is electrically reliable. Insulated.
[0018]
Further, the space 9 between the outer surface of the elastic opening / closing member 2 and the inner surface of the cylindrical flexible shaft 5 is filled with an electrically insulating silicon sealant or epoxy resin, etc. As shown, the distal ends of the pair of conductive wires 3 are respectively connected to the base ends of the pair of elastic opening and closing members 2.
[0019]
An intermediate portion of the pair of elastic opening and closing members 2 is provided with an insulating insulating chip 10 that is an electrically insulating interelectrode insulation that prevents the pair of electrodes 1 from contacting each other when the elastic opening and closing member 2 is fully closed. 6 is formed at the tip of an elongated rod-like portion 6a extending forward.
[0020]
When the pair of elastic opening / closing members 2 are fully closed and contacted from both sides, the interelectrode insulation ensuring member 10 has a spacing of, for example, 0.2 mm or more between the opposed exposed surfaces of the pair of electrodes 1. Is formed in a size that can be secured.
[0021]
With such a configuration, when the cylindrical flexible shaft 5 is advanced and retracted in the axial direction from the proximal end side (that is, the proximal side) with respect to the flexible sheath 7, a pair of elastic opening and closing members connected to the distal end thereof 2 projects from the tip of the flexible sheath 7.
[0022]
When the elastic opening / closing member 2 is drawn into the flexible sheath 7 as shown in FIG. 1, the elastic opening / closing member 2 is elastically deformed and narrowed, and as shown in FIG. When pushed out from 7, the elastic opening and closing member 2 itself expands due to elasticity. When the electrode 1 protrudes slightly from the distal end of the flexible sheath 7, the electrode 1 is in a constricted state as in FIG. 1.
[0023]
FIG. 4 shows an operation unit connected to the proximal end of the flexible sheath 7, and the contact pins 13 to which the conductive wires 3 are connected independently of each other are slidable in the axial direction of the flexible sheath 7. The second finger hook 12 is fixedly provided to the flexible sheath 7. A high frequency power cord (not shown) is connected to the contact pin 13.
[0024]
Accordingly, the elastic opening / closing member 2 can be opened / closed by sliding the first finger hook 11 with respect to the second finger hook 12, and the pair of contact pins 13 and the pair of contact pins 13 are connected via the conductive wire 3 and the elastic opening / closing member 2. Since the electrodes 1 are electrically connected to each other, as shown in FIG. 5, a high-frequency current can be passed through the tissue 100 sandwiched between the pair of electrodes 1 to cauterize and solidify.
[0025]
As shown in FIG. 6, when the tissue 100 sandwiched between the pair of electrodes 1 is a thin one such as a blood vessel or the like, even if the tissue 100 collapses due to cauterization, the elastic opening / closing member 2 Since the pair of electrodes 1 are not in contact with each other by contacting the interelectrode insulation ensuring member 10, high-frequency treatment can be performed safely.
[0026]
The present invention is not limited to the above-described embodiment. For example, as shown in FIG. 7, the flexible sheath 7 of the first embodiment is omitted and the endoscope 30 is used. The treatment tool insertion channel 31 may be directly inserted / removed. Reference numeral 32 denotes an observation window.
[0027]
Further, the interelectrode insulation ensuring member 10 may be attached in the vicinity of the edge of the facing surface of one or both electrodes 1 as shown in FIG. 8, and one or both elastic opening and closing members as shown in FIG. The inter-electrode insulation ensuring member 10 may be formed by a part of the electrical insulation coating 2 a that covers the substrate 2.
[0028]
Further, the electrode 1 may have a needle-like shape or the like as shown in FIG. 9, and the shape, material, and the like of the elastic opening / closing member 2 are not limited to the above embodiment.
[0029]
【The invention's effect】
According to the present invention, when the opening and closing member is in the closed state, the contact between the electrodes where the opposing surfaces are exposed is blocked by the inter-electrode insulation ensuring member. Even if there is a problem, it is possible to safely perform endoscopic high-frequency treatment without short-circuiting both electrodes.
[Brief description of the drawings]
FIG. 1 is a side sectional view of a distal end portion of a bipolar high-frequency treatment instrument for an endoscope according to a first embodiment of the present invention in a closed state.
FIG. 2 is a side cross-sectional view of the distal end portion of the bipolar high-frequency treatment instrument for endoscope according to the first embodiment of the present invention in an open state.
FIG. 3 is a cross-sectional view taken along the line III-III in FIG. 1 of the bipolar high-frequency treatment instrument for endoscope according to the first embodiment of the present invention.
FIG. 4 is a side cross-sectional view of the operation portion of the bipolar high-frequency treatment instrument for endoscope according to the first embodiment of the present invention.
FIG. 5 is a schematic view of the distal end portion of the bipolar high-frequency treatment instrument for endoscope according to the first embodiment of the present invention in use.
FIG. 6 is a schematic view of a distal end portion of the bipolar high frequency treatment instrument for endoscope according to the first embodiment of the present invention in use.
FIG. 7 is a side cross-sectional view of the distal end portion of the bipolar high-frequency treatment instrument for endoscope according to the second embodiment of the present invention.
FIG. 8 is a side sectional view of a distal end portion of a bipolar high-frequency treatment instrument for an endoscope according to a third embodiment of the present invention.
FIG. 9 is a side sectional view of a distal end portion of a bipolar high-frequency treatment instrument for an endoscope according to a fourth embodiment of the present invention.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Electrode 2 Elastic switching member 2a Electrical insulation coating 7 Flexible sheath 10 Interelectrode insulation ensuring member

Claims (2)

Each tip portion of the pair of opening and closing member for opening and closing I suited forward Ri by the remote control from the base end side, inner electrodes made of a conductive member is disposed in the state of being electrically insulated between each other In bipolar high frequency treatment instrument for endoscope,
An interelectrode insulation ensuring member made of an electrical insulating material that prevents the contact between the pair of electrodes when the pair of electrodes are formed by exposing the opposing surfaces and the opening / closing member is completely closed. The rod-shaped member protrudes forward from a member fixed between the base ends of the pair of opening and closing members so as to be positioned between the pair of opening and closing members and behind the electrodes . A bipolar high-frequency treatment instrument for an endoscope characterized by the above. The bipolar high-frequency treatment instrument for endoscope according to claim 1, wherein the interelectrode insulation ensuring member is formed thicker than the rod-shaped member .

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