JP4184823B2

JP4184823B2 - Endoscopic treatment tool

Info

Publication number: JP4184823B2
Application number: JP2003031561A
Authority: JP
Inventors: 功渡辺
Original assignee: Fujinon Corp
Current assignee: Fujinon Corp
Priority date: 2003-02-07
Filing date: 2003-02-07
Publication date: 2008-11-19
Anticipated expiration: 2023-02-07
Also published as: JP2004236984A

Description

【０００１】
【発明の属する技術分野】
本発明は，内視鏡用処置具にかかり，特にシングルユース用として使用される内視鏡用処置具に関する。
【０００２】
【従来の技術】
内視鏡用処置具である生検鉗子は，主に内視鏡的処置等で，例えば病変部位の粘膜の一部の採取に使用される。かかる内視鏡用生検鉗子は，操作部に連設され，内視鏡の処置具挿通チャンネルに挿脱される挿入部を備える。挿入部は，例えば密着コイル等から形成される可撓性のシースと，シースの先端部分に設けられている処置機能部となる鉗子部とから構成される。
【０００３】
上記シース内には，軸線方向に操作部と鉗子部を接続する操作ワイヤが進退自在に挿通され，シースの基端に連結された操作部において操作ワイヤを進退操作することにより，シースの先端部分に開閉自在に配置された一対の鉗子片が，操作ワイヤの進退操作に連動して開閉駆動するようになっている。
【０００４】
上記の内視鏡用処置具として，消毒，滅菌処理により再使用可能としたリユース用のものと，消毒，滅菌処理を必要としない１回限りの使用となるシングルユース用（使い切り用）のものがある（例えば，特許文献１参照）。シングルユース用の処置具は，リユース用の処置具と比べると安価に製造されて市場に供給されている。
【０００５】
【特許文献１】
特開平７−９５９８２号公報
【０００６】
【発明が解決しようとする課題】
シングルユース用の処置具でも，機能上は，再使用することが可能な場合がある。しかし，シングルユース用の処置具を再使用することによって，感染症の誘発や処置具破損等の事故が発生する虞がある。
【０００７】
このような再使用を防止するため，シングルユース用医療用処置具として，例えば上記特許文献１に記載のものもある。この処置具は，体腔内粘膜と直接触れない部分の少なくとも一部の部材を親水性を有するポリマーを含む材料で構成し，かかるポリマーを含む材料で構成した一部の部材が洗浄によって溶解，膨張あるいは柔軟化することにより，一度使用した処置具の再使用を防ぐようになっている。しかし，このような構造の処置具でも，使用者の意図しない取り扱いによって，使用前あるいは使用中に親水性を有するポリマーを含む材料部位に濡れた手で触れてしまったり，検査中に使用する患部洗浄水等が不意にこぼれて付着したりして使用不能となる虞がある。
【０００８】
そこで，本発明は，上記問題点に鑑みてなされたものであり，本発明の目的は，使用中に使用不能となることなく，使用後に確実に再使用を不能にすることができる，新規かつ改良されたシングルユース用の内視鏡用処置具を提供することである。
【０００９】
【課題を解決するための手段】
上記課題を解決するため，本発明の第１の観点によれば，挿入部を構成するシースの先端部に鉗子部を設け，挿入部の基端部に設けられた操作部によりシースに対してワイヤを進退させることにより鉗子部を開閉操作可能とする内視鏡用処置具において，操作部は，シースの基端部を支持するシース支持部と，ワイヤをシース支持部に対して進退操作可能に支持するワイヤ支持部とを設け，ワイヤ支持部またはシース支持部のいずれかに，破損容易な脆弱部を設けたことを特徴とする，内視鏡用処置具が提供される。
【００１０】
このとき，脆弱部は，ワイヤ支持部の進退方向のいずれかに鉗子部の開閉操作の範囲を越える力が作用したときに破損する程度の脆弱性を有し，かかる脆弱部は，ワイヤ支持部の進退方向のうち，鉗子部の開閉操作時に，より強い力が作用する方向とは逆方向へ鉗子部の開閉操作の範囲を越える力が作用したときに破損する程度の脆弱性を有することとしてもよい。
【００１１】
また，このときワイヤ支持部は，ワイヤの基端部に設けたワイヤカシメ部の進退方向をそれぞれ支持する壁部を有し，脆弱部は，かかる壁部のうち，鉗子部の開閉操作時に，より強い力が作用する方向とは逆方向側の壁部に形成され，かかる逆方向側の壁部の厚みを強い力が作用する方向側の壁部の厚みより薄くすることにより形成されていることとしてもよい。
【００１２】
更に，このときワイヤ支持部は，ワイヤの基端部に設けたワイヤカシメ部の進退方向をそれぞれ支持する壁部と，これらの壁部に連設してワイヤカシメ部の外周面を覆う側壁部とを有し，脆弱部は，ワイヤ支持部の側壁部外周面に沿って切欠を設け，この側壁部の一部の進退方向強度を脆弱にすることにより形成されていることとしてもよい。
【００１３】
かかる構成とすることにより，シングルユース用処置具を使用後に，使用者が意図的にワイヤ支持部に設けられた脆弱部を破損することにより，処置具を再使用不能にすることができるので，シングルユース用の処置具の再使用による感染症や処置具破損等の事故の発生を未然に防止可能となる。
【００１４】
また，このときシース支持部は，シースの基端部に設けたシースカシメ部の進退方向をそれぞれ支持する壁部と，これらの壁部のうちの少なくとも一方に連設してシースカシメ部の外周面を覆う側壁部とを有し，脆弱部は，側壁部に形成され，具体的には，シース支持部の側壁部外周面に切欠を設けて，側壁部の一部の進退方向強度を脆弱にすることにより形成されていることとしてもよい。
【００１５】
かかる構成とすることにより，シングルユース用処置具を使用後に，使用者が意図的にシース支持部に設けられた脆弱部を破損することにより，処置具を再使用不能にすることができるので，シングルユース用の処置具の再使用による感染症や処置具破損等の事故の発生を未然に防止可能となる。
【００１６】
また，このとき操作部は，シース支持部が設けられた軸体と，ワイヤ支持部が設けられ，軸体に対して進退方向に摺動操作可能な操作滑動部とを備え，軸体の操作滑動部との摺動面には，操作滑動部を少なくとも脆弱部が破損する位置以上に摺動操作したときに，操作滑動部に形成した操作滑動部側係合部と係合する軸体側係合部が形成され，かかる軸体側係合部は，軸体の操作滑動部との摺動面のうち，操作滑動部の摺動操作可能な範囲のうち少なくとも鉗子部の開閉操作範囲を越えた位置に形成してもよい。
【００１７】
このとき，具体的には，軸体の操作滑動部との摺動面には，軸体側係合部として凸部を形成し，操作滑動部の軸体との摺動面には，操作滑動部側係合部として凹部を形成したこととしてもよい。
【００１８】
かかる構成とすることにより，処置具使用後に操作滑動部を軸体に対して摺動させて凸部と凹部を嵌合させるので，未使用の処置具と使用済みの処置具との区別が容易となるので，使用済みの処置具を誤って再使用することを未然に防ぐことが出来るようになる。
【００１９】
【発明の実施の形態】
以下に添付図面を参照しながら，本発明の好適な実施の形態について詳細に説明する。なお，本明細書及び図面において，実質的に同一の機能構成を有する構成要素については，同一の符号を付することにより重複説明を省略する。
【００２０】
（第１の実施の形態）
図１は，本発明にかかる内視鏡用処置具を適用する内視鏡１００全体の概略構成図である。内視鏡１００は，主として，挿入部１０２と，操作部１０４と，ユニバーサルコード部１０６を介して接続されるコネクタ部（図示せず）とから構成されている。挿入部１０２内には，後述の内視鏡用処置具，例えば生検鉗子１１２を内視鏡先端部に導出させるための処置具挿通チャンネル１０８が設けられている。また，操作部１０４には，処置具挿通口１１０が設けられ，かかる処置具挿通口１１０は，処置具挿通チャンネル１０８に接続されている。
【００２１】
次に，本発明の第１の実施の形態にかかる内視鏡用処置具を図面を参照しながら説明する。本実施形態にかかる内視鏡用処置具として，例えば生検鉗子の全体構成図を図２に示す。なお，本実施の形態は，ワイヤ支持部に破損容易な脆弱部を設けた場合の例である。
【００２２】
同図に示される生検鉗子１１２は，使用時に術者が操作可能な操作部１１４と，使用時に上記内視鏡１００の処置具挿通口１１０から処置具挿通チャンネル１０８に挿入される挿入部１１６とを備える。
【００２３】
操作部１１４には，軸体１１８が設けられ，かかる軸体１１８の基端側には，略リング状の指掛け部１２０が装着されている。
【００２４】
また，軸体１１８には，略筒状に形成された操作滑動部１２２が軸方向に対して摺動自在に設けられている。
【００２５】
操作滑動部１２２には，操作ワイヤ１２４の基端部を支持する後述のワイヤ支持部が設けられている。
【００２６】
また，操作ワイヤ１２４は，細長で可撓性を有する密着コイル等で形成されているシース１２６を貫通して，かかる操作ワイヤ１２４の先端部が処置機能部として作用する鉗子部１２８に連結されている。更に，シース１２６の基端部を支持する後述のシース支持部が設けられている。
【００２７】
この生検鉗子１１２には，操作滑動部１２２が軸体１１８に対して操作されることにより，シース１２６に対して操作ワイヤ１２４が進退操作されて，鉗子部１２８が開閉操作されるようになっている。
【００２８】
具体的には，本実施形態の生検鉗子１１２は，操作滑動部１２２を挿入部１１６側に移動させると鉗子部１２８が開き，操作滑動部１２２を指掛け部１２０側に移動させると鉗子部１２８が閉じるようになっている。
【００２９】
次に，本実施形態の生検鉗子１１２の操作部１１４の構成の詳細を図面を用いて説明する。図３は，本実施形態の生検鉗子１１２の操作部１１４の内部構成を示す部分断面図である。
【００３０】
軸体１１８には，略全長にわたり操作滑動部１２２を進退方向にガイドするスリット１３０が形成されている。操作滑動部１２２は，内部に形成された穴に軸体１１８が挿入された状態で，上記スリット１３０に沿って，進退方向（軸方向）に移動可能になっている。
【００３１】
操作滑動部１２２に設けられたワイヤ支持部１３５は，例えば次のように構成される。スリット１３０の内側にある操作滑動部１２２の内部には，操作ワイヤ１２４の基端部に設けられたワイヤカシメ部１３２を収めるワイヤカシメ収容部１３４が形成されている。このワイヤカシメ収容部１３４にワイヤカシメ部１３２が収められることにより，操作ワイヤ１２４は，軸方向に進退操作可能に支持される。これにより，操作滑動部１２２を軸体１１８に対して摺動させると，操作ワイヤ１２４を進退方向に操作できる。なお，ワイヤ支持部１３５の詳細については，後述する。
【００３２】
操作部１１４の先端側には，シースカシメ収容部１４０が設けられ，かかるシースカシメ収容部１４０には，シース１２６の端部に設けられたシースカシメ部１３６が収められている。これにより，シース１２６は，操作部１１４に支持される。
【００３３】
また，本実施形態では，操作滑動部１２２との摺動面には，操作滑動部１２２を少なくとも脆弱部が破損する位置以上に摺動操作したときに，操作滑動部１２２に形成した操作滑動部側係合部と係合する軸体側係合部が形成されている。具体的には，軸体１１８の先端近傍の外周面に，軸体側係合部として例えば凸部１４２が形成され，操作滑動部１２２の軸体１１８に接する内側部分に，操作滑動部側係合部として例えば凹部１４４が形成されている。これにより，処置具使用者が使用後に，操作滑動部１２２を先端側に摺動させ，凹部１４４と凸部１４２とを係合させることにより，操作滑動部１２２が軸体１１８に対して摺動させることが不能になるので，生検鉗子１１２を一度使用したことがわかるようになる。
【００３４】
次に，操作ワイヤ１２４の基端部を支持するワイヤ支持部１３５の詳細について，図面を参照しながら説明する。
【００３５】
図４は，図３に示すワイヤ支持部１３５，すなわちＡ部の拡大図である。操作滑動部１２２を鉗子部１２８の通常の開閉操作の範囲を超える力が作用したときに破損されるように構成した，この脆弱部は，例えばワイヤカシメ部１３２を収めるワイヤカシメ収容部１３４の軸方向（操作滑動部１２２の進退方向）の壁部のうち基端側の壁部１３４ａの厚みの方を先端側の壁部１３４ｂの厚みより薄く形成することにより構成する。また，基端側の壁部１３４ａの厚みは，例えば操作滑動部１２２を鉗子部１２８の通常の開閉操作の範囲を超える力を作用させて，先端側へ更に移動させると，ワイヤカシメ部１３２により基端側の壁部１３４ａが押圧されることにより破損される程度の脆弱性を有する薄さとする。
【００３６】
次に，本実施形態の内視鏡用処置具の作用について，図面を参照しながら説明する。図５は，本実施形態の生検鉗子１１２の作用説明図である。
【００３７】
本実施形態では，鉗子部１２８を閉じるときは，図５（ａ）に示すように，操作滑動部１２２を指掛け部１２０側に移動させる。また，鉗子部１２８を開くときは，図５（ｂ）に示すように，操作滑動部１２２を挿入部１１６側に移動させる。
【００３８】
この鉗子部１２８の開閉操作においては，処置部位の粘膜等を掴むのに力を加えるため，通常の鉗子部１２８の開閉操作時には，鉗子部１２８を開くよりも閉じる方が操作滑動部１２２を摺動させるのに，より強い力を作用させることとなる。従って，操作滑動部１２２を基端側に摺動させる方向に，より強い力が作用される可能性が高い。
【００３９】
このため，本実施形態では，生検鉗子１１２を使用後は，（ｃ）に示すように，強い力を作用させる方向とは逆方向，すなわち操作滑動部１２２を鉗子部１２８の開閉操作の範囲外となる挿入部１１６側へ，更に移動させると，基端側の壁部１３４ａがワイヤカシメ部１３２に押圧されることにより破損される。
【００４０】
脆弱部を構成する基端側の壁部１３４ａの破損後は，操作滑動部１２２を再び挿入部１１６側に移動させても，ワイヤカシメ部１３２が基端側の壁部１３４ａに支持されなくなるため，鉗子部１２８が開かなくなる。従って，使用者は，生検鉗子１１２の開閉操作を再び行うことが不可能となる。換言すると，一度使用した生検鉗子１１２の再使用を未然に防ぐことが出来るようになる。
【００４１】
なお，脆弱部となる基端側の壁部１３４ａの破損後でも，操作滑動部１２２を基端側に移動させることにより鉗子部１２８を閉じることは出来る。この場合，外見上では，生検鉗子１１２が使用済みであるか否かの判断がつかないため，使用済みの処置具を誤使用する虞がある。
【００４２】
そこで本実施形態では，上述のような誤使用を防ぐために，生検鉗子１１２を使用後は，操作滑動部１２２を更に挿入部１１６側に摺動させて，前述したように軸体１１８の先端側の近傍に形成された凸部１４２と，操作滑動部１２２の軸体１１８に接する内側部分に形成された凹部１４４とを係合させる。
【００４３】
上記の作用により，操作滑動部１２２が軸体１１８に対して摺動させることが出来なくなる。また，鉗子部１２８が開いたままの状態となるので，処置具を一度使用したことが外見上でわかるようになる。更に，鉗子部１２８が開いたままの状態であるため，生検鉗子１１２を再び処置具挿通チャンネル１０８に挿入できなくなることより，一度使用した生検鉗子１１２の再使用を未然に防ぐことが出来るようになる。
【００４４】
次に，ワイヤ支持部１３５に設けられる脆弱部の変形例について図面を参照して説明する。図６は，本実施形態においてワイヤ支持部１３５に設けられた脆弱部の第１の変形例，図７は，第２の変形例である。
【００４５】
図６に示すように，第１の変形例では，操作滑動部１２２基端側の壁部１３４ａの端部に溝部１４６が形成されている。かかる構成とすることにより，基端側の壁部１３４ａが操作滑動部１２２を鉗子部１２８の通常の開閉操作の範囲を超える力が作用したときに溝部１４６がより破損され易くなる。
【００４６】
また，図６は，一体で形成した例を示したが，図７に示すように，ワイヤカシメ収容部１３４が形成されるワイヤ支持部１３５を操作滑動部１２２と別体にしてもよい。この場合，ワイヤ支持部１３５は，側壁部の外周面に沿って切欠部１４８が形成されている。そして，操作滑動部１２２のフランジ部１２２ａに形成された孔（図示せず）から切欠部１４８にそれぞれ挿通された支持部材１５０により，ワイヤ支持部１３５は，操作滑動部１２２に対して支持される。これにより，軸体１１８に対しワイヤ支持部１３５と操作滑動部１２２とが一体となって摺動されるようになる。
【００４７】
この第２の変形例では，ワイヤカシメ収容部１３４の基端側の壁部１３４ａを脆弱部にしてもよく，また支持部材１５０を支持する突出部１３５ａを脆弱部としてもよい。操作滑動部１２２を鉗子部１２８の通常の開閉操作の範囲を超える力が作用したとき，基端側の壁部１３４ａまたはワイヤ支持部１３５の基端側の突出部１３５ａが破損され，使用者が生検鉗子１１２の開閉操作を再び行うことが不可能となり，一度使用した生検鉗子１１２の再使用を未然に防ぐことが出来るようになる。
【００４８】
（第２の実施の形態）
次に，本発明の第２の実施の形態にかかる内視鏡用処置具，例えば生検鉗子を図面を参照しながら説明する。本実施形態にかかる生検鉗子の全体の概略構成図は，図２に示すものと同様である。
【００４９】
図８は，第２の実施の形態の生検鉗子２１２の操作部２１４の内部構成を示す部分断面図である。なお，本実施の形態にかかる生検鉗子２１２の操作部は，第１の実施の形態のものとほぼ同様であるが，ワイヤ支持部２３５には脆弱部を設けずに，シース支持部２３９に脆弱部を設けている点で第１の実施の形態のものと異なる。
【００５０】
本実施の形態にかかる生検鉗子２１２の軸体２１８には，略全長にわたり操作滑動部２２２を進退方向にガイドするスリット２３０が形成されている。かかるスリット２３０の内側にある操作滑動部２２２の内部には，操作ワイヤ２２４の基端部に設けられたワイヤカシメ部２３２を収めるワイヤカシメ収容部２３４が形成されている。このワイヤカシメ収容部２３４にワイヤカシメ部２３２が収められることにより，操作ワイヤ２２４は，軸方向に進退操作可能に支持される。これにより，操作滑動部２２２を軸体２１８に対して摺動させると，操作ワイヤ２２４を進退方向に操作できる。
【００５１】
操作部２１４の先端部には，シース２２６の基端部を支持するシース支持部２３９が設けられている。このシース支持部２３９は，例えば図９に示すように構成される。すなわち，操作部２１４における軸体２１８の先端部には，シース２２６の基端部を装着するシース取付け部材２３８を取付けるための取付け孔２３３が形成されている。なお，シース支持部２３９の詳細は，後述する。
【００５２】
また，操作滑動部２２２との摺動面には，第１の実施形態と同様に操作滑動部２２２を少なくとも脆弱部が破損する位置以上に摺動操作したときに，操作滑動部２２２に形成した操作滑動部側係合部例えば凹部２４４と，係合する軸体側係合部例えば凸部２４２が形成されている。これにより，処置具使用者が使用後に，操作滑動部２２２を先端側に摺動させ，凹部２４４と凸部２４２とを係合させることにより，操作滑動部２２２が軸体２１８に対して摺動させることが出来なくなるので，処置具を一度使用したことがわかるようになる。
【００５３】
次に，シース２２６の基端部を支持するシース支持部２３９の詳細について図面を参照しながら説明する。
【００５４】
図９は，図８に示すシース支持部２３９，すなわちＢ部の拡大図である。図９に示すように，シース取付け部材２３８には，その基端から開口した開口部が設けられ，この開口部にシースカシメ部２３６が収められる。この開口部は，シースカシメ収容部２４０における軸方向一方側の壁部２３１と側壁部２３７を構成する。シース取付け部材２３８の開口端は，軸体２１８先端部の取付け孔２３３を構成する壁に当接しており，この壁は，シースカシメ収容部２４０の軸方向他方側の壁部２４１を構成する。こうして，シースカシメ部２３６の軸方向は，シースカシメ収容部２４０を構成するシース取付け部材２３８の壁部２３１と軸体２１８の壁部２４１により支持される。
【００５５】
上記軸体２１８の取付け孔２３３の内側面には，雌ねじ部２５２が形成されている。この雌ねじ部２５２の根元側（操作部２１４の基端側）には，雌ねじ逃げ部２４８が形成されている。この雌ねじ逃げ部２４８は，軸体２１８の先端部の取付け孔２３３内側の内周に沿って切欠を設けることにより形成される。
【００５６】
一方，シース取付け部材２３８の軸体２１８側の端部の外側面には，雄ねじ部２５０が形成されている。この雄ねじ部２５０は，上記軸体２１８の先端部に設けられた雌ねじ部２５２に螺着される。この雄ねじ部２５０の根元側（操作部２１４の先端側）には，雄ねじ逃げ部２４６が形成されている。この雄ねじ逃げ部２４６は，シース取付け部材２３８の外周に沿って切欠を設けることにより形成される。
【００５７】
このように，軸体２１８の先端部とシース取付け部材２３８とを螺着することにより，軸体２１８にシース取付け部材２３８を軸方向に容易に取付けることができる。
【００５８】
本実施形態のシース支持部２３９には，操作滑動部２２２を鉗子部２２８の通常の開閉操作の範囲を超える力が作用したときに破損されるように構成した脆弱部を設ける。本実施の形態では，例えば上記雄ねじ逃げ部２４６，雌ねじ部逃げ部２４８のいずれか一方を脆弱部とする。
【００５９】
すなわち，本実施の形態における脆弱部は，雄ねじ逃げ部２４６または雌ねじ部逃げ部２４８が形成される部位の厚みを薄くして，この部位の軸方向（操作滑動部２２２の進退方向）に対する強度を低くすることにより形成する。
【００６０】
雄ねじ逃げ部２４６または雌ねじ部逃げ部２４８が形成される部位の厚みは，次のような脆弱性を有する程度とする。すなわち操作滑動部２２２を鉗子部２２８の通常の開閉操作範囲外となる先端側へ更に移動させると，シースカシメ部２３６によりシースカシメ収容部２４０の先端側の壁部２３１が押圧される。
【００６１】
従って本実施形態では，シースカシメ部２３６によりシースカシメ収容部２４０の先端側の壁部２３１が押圧されることにより，雄ねじ逃げ部２４６または雌ねじ部逃げ部２４８が破損される程度の脆弱性を有するように上記脆弱部を形成する。
【００６２】
これにより，操作滑動部２２２を通常の鉗子部２２８の開閉操作範囲外に移動させることにより，雄ねじ逃げ部２４６または雌ねじ部逃げ部２４８が破損されるので，生検鉗子２１２の再使用が出来なくなる。
【００６３】
なお，本実施の形態では，雄ねじ逃げ部２４６または雌ねじ逃げ部２４８が破損する前に，雄ねじ部２５０および雌ねじ部２５２が破損しないようにするため，雄ねじ部２５０および雌ねじ部２５２の軸方向（操作ワイヤ２２４の進退方向）の強度は，雄ねじ逃げ部２４６および雌ねじ逃げ部２４８の軸方向の強度より大きいことが必要である。
【００６４】
次に，シース支持部２３９の構成の変形例について図面を参照して説明する。図９に示すものでは，シースカシメ部２３６をシース取付け部材２３８に装着する場合について説明したが，シースカシメ部２３６を軸体２１８の先端部に備えた場合の構成例を図１０に示す。
【００６５】
図１０に示す変形例におけるシース支持部３３９は，次のように構成される。操作部２１４における軸体３１８の先端部には，軸体３１８の外径よりも小さい径の段部３５１が形成されている。この段部３５１内には，先端側が開口する開口部が設けられ，この開口部にシースカシメ部３３６が装着される。軸体３１８の段部３５１内の開口部を構成する側壁と軸方向の壁は，それぞれシースカシメ収容部３４０の側壁部３３７と軸方向他方側の壁３４１を構成する。
【００６６】
軸体３１８の段部３５１の開口端は，シース取付け部材３３８の取付け孔３３３を構成する壁に当接しており，この壁は，シースカシメ収容部３４０の軸方向一方側の壁部３３１を構成する。こうして，シースカシメ部３３６の軸方向は，シースカシメ収容部３４０を構成するシース取付け部材３３８の壁部３３１と軸体３１８の壁部３４１により支持される。
【００６７】
上記軸体３１８の段部３５１の外側の側面に当接するように，シース取付け部材３３８の軸体３１８側の端部には，取付け孔３３３が設けられている。この取付け孔３３３の内側面には，雌ねじ部３５２が形成されている。この雌ねじ部３５２の根元側（操作部２１４の先端側）には，雌ねじ逃げ部３４８が形成されている。この雌ねじ逃げ部３４８は，シース取付け部材３３８の内周に沿って切欠を設けることにより形成される。
【００６８】
また，上記の段部３５１の外側面には，雄ねじ部３５０が形成されている。この雄ねじ部３５０の根元側（操作部２１４の基端側）には，雄ねじ逃げ部３４６が形成されている。この雄ねじ逃げ部３４６は，軸体３１８の段部３５１外周に沿って切欠を設けることにより形成される。このようにしても，図９に示すものと同様に軸体３１８にシース取付け部材３３８を軸方向に容易に取付けることができる。
【００６９】
図１０に示すシース支持部３３９には，操作滑動部２２２を鉗子部２２８の通常の開閉操作の範囲を超える力が作用したときに破損されるように構成した脆弱部を設ける。本変形例では，例えば上記雄ねじ逃げ部３４６，雌ねじ部逃げ部３４８のいずれか一方を脆弱部とする。
【００７０】
すなわち，本変形例における脆弱部は，雄ねじ逃げ部３４６または雌ねじ部逃げ部３４８が形成される部位の厚みを薄くして，この部位の軸方向（操作滑動部２２２の進退方向）に対する強度を低くすることにより形成する。
【００７１】
雄ねじ逃げ部３４６または雌ねじ部逃げ部３４８が形成される部位の厚みは，次のような脆弱性を有する程度とする。すなわち本変形例においても，図９で示す実施形態と同様に，操作滑動部２２２を鉗子部２２８の通常の開閉操作範囲外となる先端側へ更に移動させると，シースカシメ部３３６によりシースカシメ収容部３４０の先端側の壁部３３１が押圧されることにより，雄ねじ逃げ部３４６または雌ねじ逃げ部３４８が破損される程度の脆弱性を有するように上記脆弱部を形成する。
【００７２】
これにより，雄ねじ逃げ部３４６または雌ねじ逃げ部３４８が操作滑動部２２２を通常の鉗子部２２８の開閉操作範囲外に移動させることにより破損されるので，生検鉗子２１２の再使用が出来なくなる。
【００７３】
なお，本変形例においても，雄ねじ逃げ部３４６または雌ねじ逃げ部３４８が破損する前に，雄ねじ部３５０または雌ねじ部３５２が破損しないようにするため，雄ねじ部３５０および雌ねじ部３５２の軸方向（操作ワイヤ３２４の進退方向）の強度は，雄ねじ逃げ部３４６および雌ねじ逃げ部３４８の軸方向の強度より大きいことが必要である。
【００７４】
次に，本実施形態の内視鏡用処置具の作用について，図面を参照しながら説明する。図１１は，本実施形態の生検鉗子２１２の作用説明図である。同図において，シース支持部２３９近傍は，部分的に断面図で示す。
【００７５】
本実施形態では，第１の実施の形態と同様に，鉗子部２２８を閉じるときは，図１１（ａ）に示すように，操作滑動部２２２を指掛け部２２０側に移動させる。また，鉗子部２２８を開くときは，図１１（ｂ）に示すように，操作滑動部２２２を挿入部２１６側に移動させる。従って，第１の実施の形態と同様に，鉗子部２２８の通常の開閉操作時は，鉗子部２２８を閉じる方向，つまり操作滑動部２２２を基端側に摺動させる方向により強い力が作用する可能性が高い。
【００７６】
このため本実施形態では，生検鉗子２１２を使用後は，図１１（ｃ）に示すように，強い力を作用させる方向とは逆方向，すなわち操作滑動部２２２を鉗子部２２８の開閉操作の範囲外となる挿入部２１６側へ更に移動させると，シース取付け部材２３８内に設けられたシースカシメ収容部２４０の先端側の壁部２３１ａがシースカシメ部２３６に押圧される。この壁部２３１ａが押圧されることによって，脆弱部となる雄ねじ逃げ部２４６が破損されて，この雄ねじ逃げ部２４６より先端側のシース取付け部材２３８が抜けていく。
【００７７】
本実施形態では，第１の実施の形態と同様に，脆弱部となる雄ねじ逃げ部２４６の破損後でも，操作滑動部２２２を基端側に移動させることにより鉗子部２２８を閉じることは出来る。しかし，操作滑動部２２２を再び挿入部２１６側に移動させても，雄ねじ逃げ部２４６より先端側のシース取付け部材２３８が抜け落ちてしまい，シースカシメ部２３６がシースカシメ収容部２４０の先端側の壁部２３１ａに支えられなくなるために，鉗子部２２８が開かなくなる。このため使用者は，生検鉗子２１２の開閉操作を再び行うことが不可能となる。これにより，一度使用した生検鉗子２１２の再使用を未然に防ぐことが出来るようになる。
【００７８】
しかも，本実施形態では，上述したように，操作滑動部２２２を鉗子部２２８の開閉操作範囲外となる先端側に移動させることにより，雄ねじ逃げ部２４６より先端側のシース取付け部材２３８が抜け落ちてしまうので，生検鉗子２１２が使用済みであるか否かを容易に判断できる。このため，使用済みの処置具の誤使用を未然に防ぐことが出来る。従って，第２の実施の形態では，上述した操作滑動部側係合部例えば凹部２４４と軸体側係合部例えば凸部２４２を形成しなくても，生検鉗子２１２が使用済みであるか否かを容易に判断できる。
【００７９】
また，本実施形態では，雄ねじ逃げ部２４６または雌ねじ逃げ部２４８を脆弱部としているため，操作滑動部２２２を通常の鉗子部２２８の開閉操作範囲外に移動させることにより雌ねじ逃げ部２４８が先に破損されることもある。このときは，雌ねじ逃げ部２４８より先端側の軸体２１８とシース取付け部材２３８とが同時に抜け落ちることにより，生検鉗子２１２の開閉操作を再び行うことが不可能となる。
【００８０】
以上，添付図面を参照しながら本発明の好適な実施形態について説明したが，本発明はかかる例に限定されない。当業者であれば，特許請求の範囲に記載された技術的思想の範疇内において各種の変更例または修正例に想到し得ることは明らかであり，それらについても当然に本発明の技術的範囲に属するものと了解される。
【００８１】
例えば，本発明の第１および第２の実施の形態では，内視鏡用処置具のうち生検鉗子について取り上げているが，操作部，挿入部から構成されるような，生検鉗子と同様な構成の把持鉗子等の内視鏡用処置具も，本実施形態と同様な構成，作用とすることにより，やはり同様に再使用防止が可能なシングルユース用の処置具として使用することができる。
【００８２】
また，本発明の第１および第２の実施の形態では，鉗子部が閉じる方向により強い力を作用させて操作滑動部を軸体に対して摺動させる処置具について取り上げているが，鉗子部の開閉操作時に，鉗子部を開く方向により強い力を作用させる処置具においては，脆弱部をワイヤ支持部の先端側に設けることにより，同様の効果が得られる。
【００８３】
更に，第１および第２の実施の形態では，ワイヤ支持部またはシース支持部のいずれかに，破損容易な脆弱部を設けているが，ワイヤ支持部およびシース支持部の双方に脆弱部を設けてもよい。このとき，脆弱部破損後に使用済みであることが容易に出来るようにするために，シース支持部の脆弱部の方の脆弱性が強い方が好ましい。
【００８４】
【発明の効果】
以上説明したように，本発明によれば，ワイヤ支持部またはシース支持部に設けた脆弱部を使用後に破損することにより，使用済みのシングルユース用の処置具の再使用を不可能にすることができるので，使用済み処置具の再使用による感染症や処置具破損等の事故の発生を未然に防止することが可能となる。
【図面の簡単な説明】
【図１】内視鏡全体の概略構成図である。
【図２】内視鏡用処置具の全体構成図である。
【図３】第１の実施の形態の内視鏡用処置具の操作部の内部構成を示す部分断面図である。
【図４】図３でのＡ部の拡大図である。
【図５】第１の実施の形態の内視鏡用処置具の作用説明図である。
【図６】第１の実施の形態の内視鏡用処置具に設けられた脆弱部の他の変形例である。
【図７】第１の実施の形態の内視鏡用処置具に設けられた脆弱部の他の変形例である。
【図８】第２の実施の形態の内視鏡用処置具の操作部の内部構成を示す部分断面図である。
【図９】図８でのＢ部の拡大図である。
【図１０】第２の実施の形態の内視鏡用処置具に設けられた脆弱部の他の変形例である。
【図１１】第２の実施の形態の内視鏡用処置具の作用説明図である。
【符号の説明】
１００内視鏡
１０２挿入部
１０４操作部
１０６ユニバーサルコード部
１０８処置具挿通チャンネル
１１０処置具挿通口
１１２，２１２生検鉗子
１１４，２１４操作部
１１６，２１６挿入部
１１８，２１８，３１８軸体
１２０，２２０指掛け部
１２２，２２２操作滑動部
１２４，２２４，３２４操作ワイヤ
１２６，２２６，３２６シース
１２８，２２８鉗子部
１３０，２３０スリット
１３２，２３２ワイヤカシメ部
１３４，２３４ワイヤカシメ収容部
１３５，２３５ワイヤ支持部
１３６，２３６，３３６シースカシメ部
１３８，２３８，３３８シース取付け部材
１３９，２３９，３３９シース支持部
１４０，２４０，３４０シースカシメ収容部
１４２，２４２凸部
１４４，２４４凹部
１４６溝部
１４８切欠部
１５０支持部材
２３１，２４１，３３１，３４１壁部
２３３，３３３取付け孔
２３７，３３７側壁部
２４６，３４６雄ねじ逃げ部
２４８，３４８雌ねじ逃げ部
２５０，３５０雄ねじ部
２５２，３５２雌ねじ部
３５１段部[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an endoscope treatment tool, and more particularly to an endoscope treatment tool used for single use.
[0002]
[Prior art]
A biopsy forceps that is a treatment tool for an endoscope is mainly used for endoscopic treatment or the like, for example, to collect a part of a mucous membrane at a lesion site. Such an endoscopic biopsy forceps includes an insertion portion that is connected to an operation portion and is inserted into and removed from a treatment instrument insertion channel of the endoscope. An insertion part is comprised from the forceps part used as the treatment function part provided in the front-end | tip part of a flexible sheath formed, for example from a close_contact | adherence coil.
[0003]
An operation wire that connects the operation portion and the forceps portion in the axial direction is inserted into the sheath so as to be able to advance and retreat. By operating the operation wire in the operation portion connected to the proximal end of the sheath, the distal end portion of the sheath A pair of forceps pieces arranged to be freely opened and closed are driven to open and close in conjunction with the advancement and retraction operation of the operation wire.
[0004]
As the above-mentioned endoscope treatment tools, those that can be reused by disinfection and sterilization, and those that are single-use (use-up) that can be used only once and do not require disinfection and sterilization. (See, for example, Patent Document 1). Single-use treatment tools are manufactured at a lower cost than the reuse treatment tools and are supplied to the market.
[0005]
[Patent Document 1]
Japanese Patent Laid-Open No. 7-95982
[0006]
[Problems to be solved by the invention]
Even single-use instruments may be reusable functionally. However, reusing a single-use treatment tool may cause an accident such as induction of infection or damage to the treatment tool.
[0007]
In order to prevent such re-use, there is a single-use medical treatment instrument described in Patent Document 1, for example. In this treatment tool, at least a part of the part that does not directly contact the mucous membrane in the body cavity is made of a material containing a hydrophilic polymer, and the part made of the material containing the polymer is dissolved and expanded by washing. Or, it is designed to prevent reuse of treatment tools once used by making them flexible. However, even with a treatment tool with such a structure, the affected part that is used during the examination may come into contact with a wet polymer part containing a hydrophilic polymer before or during use due to unintended handling by the user. There is a risk that the cleaning water or the like may spill and adhere, making it unusable.
[0008]
Therefore, the present invention has been made in view of the above-mentioned problems, and the object of the present invention is a novel and capable of reliably disabling reuse after use without being disabled during use. An improved single-use endoscope treatment tool is provided.
[0009]
[Means for Solving the Problems]
In order to solve the above-described problem, according to the first aspect of the present invention, a forceps portion is provided at the distal end portion of the sheath constituting the insertion portion, and the operation portion provided at the proximal end portion of the insertion portion is attached to the sheath. In an endoscopic treatment instrument that can open and close the forceps by moving the wire forward and backward, the operation part can be operated to advance and retract the sheath support part that supports the proximal end part of the sheath and the wire with respect to the sheath support part. An endoscopic treatment instrument is provided in which a wire support portion is provided on the wire support portion, and a fragile portion that is easily damaged is provided in either the wire support portion or the sheath support portion.
[0010]
At this time, the fragile portion has a fragility to such an extent that the fragile portion is damaged when a force exceeding the range of opening / closing operation of the forceps portion is applied to any of the advancement and retraction directions of the wire support portion. Among the advance and retreat directions of the forceps, when the forceps part is opened and closed, it is vulnerable to damage when a force exceeding the range of forceps part opening and closing is applied in the opposite direction. Also good.
[0011]
Further, at this time, the wire support portion has wall portions that respectively support the forward and backward directions of the wire caulking portion provided at the proximal end portion of the wire. It is formed on the wall on the side opposite to the direction in which the strong force acts, and is formed by making the thickness of the wall on the opposite side thinner than that on the direction in which the strong force acts. It is good.
[0012]
Further, at this time, the wire support portion includes a wall portion that supports the forward and backward directions of the wire crimping portion provided at the proximal end portion of the wire, and a side wall portion that is connected to these wall portions and covers the outer peripheral surface of the wire crimping portion. The weak portion may be formed by providing a notch along the outer peripheral surface of the side wall portion of the wire support portion and weakening the strength in the advancing / retreating direction of a part of the side wall portion.
[0013]
By adopting such a configuration, the user can intentionally break the fragile part provided in the wire support part after using the single-use treatment tool, thereby making the treatment tool non-reusable. Occurrence of accidents such as infections and damage to treatment tools due to reuse of treatment tools for single use can be prevented.
[0014]
At this time, the sheath support portion includes a wall portion that supports the forward and backward directions of the sheath caulking portion provided at the proximal end portion of the sheath, and an outer peripheral surface of the sheath caulking portion that is connected to at least one of these wall portions. The weak part is formed in the side wall part. Specifically, a notch is provided in the outer peripheral surface of the side wall part of the sheath support part to weaken the strength in the advancing / retreating part of the side wall part. It is good also as being formed by.
[0015]
By adopting such a configuration, after using the treatment tool for single use, the user can intentionally break the fragile portion provided in the sheath support portion, thereby making the treatment tool non-reusable. Occurrence of accidents such as infections and damage to treatment tools due to reuse of treatment tools for single use can be prevented.
[0016]
Further, at this time, the operation part includes a shaft body provided with a sheath support part and an operation slide part provided with a wire support part and capable of sliding in the forward and backward directions with respect to the shaft body. The sliding surface with the sliding portion includes a shaft body side engagement that engages with the operating sliding portion side engaging portion formed in the operating sliding portion when the operating sliding portion is slid beyond the position where at least the fragile portion is damaged. A joint portion is formed, and the shaft body side engaging portion exceeds at least the opening / closing operation range of the forceps portion of the sliding surface of the shaft sliding portion with respect to the operation sliding portion of the operation sliding portion. You may form in a position.
[0017]
At this time, specifically, a convex portion is formed as a shaft body side engaging portion on the sliding surface of the shaft body with the operation sliding portion, and the operation sliding portion is formed on the sliding surface of the operation sliding portion with the shaft body. It is good also as having formed the recessed part as a part side engaging part.
[0018]
By adopting such a configuration, the operation sliding portion is slid with respect to the shaft body after the treatment tool is used, and the convex portion and the concave portion are fitted, so that it is easy to distinguish between the unused treatment tool and the used treatment tool. Therefore, it becomes possible to prevent the used treatment tool from being reused by mistake.
[0019]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, preferred embodiments of the present invention will be described in detail with reference to the accompanying drawings. In the present specification and drawings, components having substantially the same functional configuration are denoted by the same reference numerals, and redundant description is omitted.
[0020]
(First embodiment)
FIG. 1 is a schematic configuration diagram of an entire endoscope 100 to which an endoscope treatment tool according to the present invention is applied. The endoscope 100 mainly includes an insertion portion 102, an operation portion 104, and a connector portion (not shown) connected via a universal cord portion 106. In the insertion portion 102, a treatment instrument insertion channel 108 is provided for leading an endoscope treatment tool, for example, a biopsy forceps 112 described later, to the distal end portion of the endoscope. The operation unit 104 is provided with a treatment instrument insertion port 110, and the treatment instrument insertion port 110 is connected to the treatment instrument insertion channel 108.
[0021]
Next, an endoscope treatment tool according to a first embodiment of the present invention will be described with reference to the drawings. As an endoscope treatment tool according to the present embodiment, for example, an overall configuration diagram of a biopsy forceps is shown in FIG. In addition, this Embodiment is an example at the time of providing the fragile part which is easy to break in the wire support part.
[0022]
The biopsy forceps 112 shown in the figure includes an operation unit 114 that can be operated by an operator during use, and an insertion unit 116 that is inserted into the treatment instrument insertion channel 108 from the treatment instrument insertion port 110 of the endoscope 100 during use. With.
[0023]
The operation unit 114 is provided with a shaft body 118, and a substantially ring-shaped finger hook 120 is attached to the proximal end side of the shaft body 118.
[0024]
Further, the shaft body 118 is provided with an operation sliding portion 122 formed in a substantially cylindrical shape so as to be slidable in the axial direction.
[0025]
The operation sliding portion 122 is provided with a wire support portion described later that supports the proximal end portion of the operation wire 124.
[0026]
Further, the operation wire 124 passes through a sheath 126 formed of an elongated and flexible contact coil or the like, and the distal end portion of the operation wire 124 is connected to a forceps portion 128 that acts as a treatment function portion. Yes. Further, a sheath support portion described later for supporting the proximal end portion of the sheath 126 is provided.
[0027]
In the biopsy forceps 112, when the operation sliding portion 122 is operated with respect to the shaft body 118, the operation wire 124 is moved forward and backward with respect to the sheath 126, and the forceps portion 128 is opened and closed. ing.
[0028]
Specifically, in the biopsy forceps 112 according to the present embodiment, when the operation sliding portion 122 is moved to the insertion portion 116 side, the forceps portion 128 is opened, and when the operation sliding portion 122 is moved to the finger hooking portion 120 side, the forceps portion 128 is opened. Is supposed to close.
[0029]
Next, details of the configuration of the operation unit 114 of the biopsy forceps 112 of the present embodiment will be described with reference to the drawings. FIG. 3 is a partial cross-sectional view showing the internal configuration of the operation unit 114 of the biopsy forceps 112 of the present embodiment.
[0030]
The shaft body 118 is formed with a slit 130 that guides the operation sliding portion 122 in the forward / backward direction over substantially the entire length. The operation sliding portion 122 is movable in the forward / backward direction (axial direction) along the slit 130 in a state where the shaft body 118 is inserted into a hole formed therein.
[0031]
The wire support part 135 provided in the operation slide part 122 is comprised as follows, for example. Inside the operation sliding portion 122 inside the slit 130, a wire caulking accommodating portion 134 for accommodating the wire caulking portion 132 provided at the proximal end portion of the operation wire 124 is formed. By accommodating the wire crimping portion 132 in the wire crimping accommodation portion 134, the operation wire 124 is supported so as to be able to advance and retract in the axial direction. Thus, when the operation sliding portion 122 is slid with respect to the shaft body 118, the operation wire 124 can be operated in the forward / backward direction. Details of the wire support portion 135 will be described later.
[0032]
A sheath caulking accommodating portion 140 is provided at the distal end side of the operation portion 114, and a sheath caulking portion 136 provided at an end portion of the sheath 126 is accommodated in the sheath caulking accommodating portion 140. As a result, the sheath 126 is supported by the operation unit 114.
[0033]
Further, in the present embodiment, the sliding surface formed with the operation sliding portion 122 is formed on the sliding surface with the operation sliding portion 122 when the operation sliding portion 122 is slid at least at a position where the fragile portion is damaged. A shaft body side engaging portion that engages with the side engaging portion is formed. Specifically, for example, a convex portion 142 is formed on the outer peripheral surface in the vicinity of the tip of the shaft body 118 as a shaft body side engaging portion, and the inner side portion of the operation sliding portion 122 in contact with the shaft body 118 is engaged with the operation sliding portion side engagement. For example, a concave portion 144 is formed as the portion. Thereby, after the treatment tool user uses, the operation sliding portion 122 slides with respect to the shaft body 118 by sliding the operation sliding portion 122 toward the distal end and engaging the concave portion 144 with the convex portion 142. Since it becomes impossible to make it, it turns out that the biopsy forceps 112 was used once.
[0034]
Next, details of the wire support portion 135 that supports the proximal end portion of the operation wire 124 will be described with reference to the drawings.
[0035]
FIG. 4 is an enlarged view of the wire support portion 135, that is, the A portion shown in FIG. The operation sliding portion 122 is configured so as to be broken when a force exceeding the normal opening / closing operation range of the forceps portion 128 is applied. This weak portion is, for example, the axial direction of the wire caulking housing portion 134 that houses the wire caulking portion 132 ( Of the wall portion in the forward / backward direction of the operation sliding portion 122, the base end side wall portion 134 a is formed thinner than the distal end side wall portion 134 b. Further, the thickness of the wall 134a on the proximal end side is determined by the wire caulking portion 132 when the operation sliding portion 122 is further moved to the distal end side by applying a force exceeding the normal opening / closing operation range of the forceps 128, for example. The thin wall portion 134a is so thin that it is broken when the end-side wall portion 134a is pressed.
[0036]
Next, the operation of the endoscope treatment tool of this embodiment will be described with reference to the drawings. FIG. 5 is an explanatory diagram of the operation of the biopsy forceps 112 of the present embodiment.
[0037]
In this embodiment, when closing the forceps part 128, the operation sliding part 122 is moved to the finger hooking part 120 side as shown in FIG. Further, when opening the forceps portion 128, as shown in FIG. 5B, the operation sliding portion 122 is moved to the insertion portion 116 side.
[0038]
In the opening / closing operation of the forceps portion 128, a force is applied to grasp the mucous membrane or the like of the treatment site. Therefore, when the opening / closing operation of the normal forceps portion 128 is performed, the operation sliding portion 122 is slid by closing rather than opening the forceps portion 128. To move it, a stronger force is applied. Therefore, there is a high possibility that a stronger force is applied in the direction in which the operation sliding portion 122 is slid toward the base end side.
[0039]
For this reason, in this embodiment, after using the biopsy forceps 112, as shown in (c), the direction opposite to the direction in which a strong force is applied, that is, the operation sliding portion 122 is within the range of opening / closing operation of the forceps portion 128. When further moved further toward the insertion portion 116 side, the wall portion 134a on the proximal end side is damaged by being pressed by the wire crimping portion 132.
[0040]
After the base end side wall portion 134a constituting the fragile portion is broken, the wire caulking portion 132 is not supported by the base end side wall portion 134a even if the operation sliding portion 122 is moved again to the insertion portion 116 side. The forceps 128 does not open. Therefore, the user cannot perform the opening / closing operation of the biopsy forceps 112 again. In other words, reuse of the biopsy forceps 112 once used can be prevented in advance.
[0041]
Note that the forceps 128 can be closed by moving the operation sliding portion 122 to the proximal end side even after breakage of the proximal end side wall portion 134a that becomes a fragile portion. In this case, since it is not possible to determine whether or not the biopsy forceps 112 have been used in appearance, there is a possibility that the used treatment tool may be misused.
[0042]
Therefore, in the present embodiment, in order to prevent the above-described misuse, after using the biopsy forceps 112, the operation sliding portion 122 is further slid to the insertion portion 116 side, and the tip of the shaft body 118 as described above. The convex part 142 formed in the vicinity of the side is engaged with the concave part 144 formed in the inner part in contact with the shaft body 118 of the operation sliding part 122.
[0043]
Due to the above action, the operation sliding portion 122 cannot be slid with respect to the shaft body 118. Further, since the forceps portion 128 remains open, it can be seen from the outside that the treatment tool has been used once. Furthermore, since the forceps portion 128 remains open, the biopsy forceps 112 cannot be inserted into the treatment instrument insertion channel 108 again, so that it is possible to prevent reuse of the biopsy forceps 112 once used. It becomes like this.
[0044]
Next, a modified example of the weak part provided in the wire support part 135 will be described with reference to the drawings. FIG. 6 shows a first modification of the weakened portion provided in the wire support part 135 in the present embodiment, and FIG. 7 shows a second modification.
[0045]
As shown in FIG. 6, in the first modification, a groove 146 is formed at the end of the wall 134 a on the base end side of the operation sliding portion 122. With this configuration, the groove portion 146 is more easily damaged when a force exceeding the normal opening / closing operation range of the forceps 128 is applied to the operation sliding portion 122 by the proximal wall portion 134a.
[0046]
Further, FIG. 6 shows an example in which they are formed integrally, but as shown in FIG. 7, the wire support part 135 in which the wire caulking accommodation part 134 is formed may be separated from the operation sliding part 122. In this case, the wire support portion 135 has a notch 148 formed along the outer peripheral surface of the side wall portion. The wire support portion 135 is supported by the operation slide portion 122 by the support members 150 respectively inserted into the notches 148 from holes (not shown) formed in the flange portion 122a of the operation slide portion 122. . As a result, the wire support portion 135 and the operation sliding portion 122 are integrally slid with respect to the shaft body 118.
[0047]
In the second modification, the proximal wall portion 134a of the wire crimping accommodation portion 134 may be a weak portion, and the protruding portion 135a that supports the support member 150 may be a weak portion. When a force exceeding the normal opening / closing operation range of the forceps portion 128 is applied to the operation sliding portion 122, the proximal-side wall portion 134a or the proximal-side protruding portion 135a of the wire support portion 135 is damaged, and the user It becomes impossible to open and close the biopsy forceps 112 again, and it is possible to prevent reuse of the biopsy forceps 112 once used.
[0048]
(Second Embodiment)
Next, an endoscope treatment tool, for example, a biopsy forceps according to a second embodiment of the present invention will be described with reference to the drawings. An overall schematic configuration diagram of the biopsy forceps according to the present embodiment is the same as that shown in FIG.
[0049]
FIG. 8 is a partial cross-sectional view illustrating an internal configuration of the operation unit 214 of the biopsy forceps 212 according to the second embodiment. The operation part of the biopsy forceps 212 according to the present embodiment is substantially the same as that of the first embodiment, but the wire support part 235 is not provided with the weak part, and the sheath support part 239 is provided. It differs from the thing of 1st Embodiment by the point which has provided the weak part.
[0050]
The shaft body 218 of the biopsy forceps 212 according to the present embodiment is formed with a slit 230 that guides the operation sliding portion 222 in the forward / backward direction over substantially the entire length. Inside the operation sliding portion 222 inside the slit 230, a wire crimping accommodation portion 234 for accommodating the wire crimping portion 232 provided at the proximal end portion of the operation wire 224 is formed. By accommodating the wire crimping portion 232 in the wire crimping accommodation portion 234, the operation wire 224 is supported so as to be able to advance and retract in the axial direction. Thus, when the operation sliding portion 222 is slid with respect to the shaft body 218, the operation wire 224 can be operated in the forward and backward directions.
[0051]
A sheath support portion 239 that supports the proximal end portion of the sheath 226 is provided at the distal end portion of the operation portion 214. The sheath support portion 239 is configured as shown in FIG. 9, for example. That is, an attachment hole 233 for attaching the sheath attachment member 238 for attaching the proximal end portion of the sheath 226 is formed at the distal end portion of the shaft body 218 in the operation portion 214. Details of the sheath support portion 239 will be described later.
[0052]
Further, the sliding surface with the operation sliding portion 222 is formed on the operation sliding portion 222 when the operation sliding portion 222 is slid at least at a position where the fragile portion is damaged as in the first embodiment. An operation sliding part side engaging part, for example, a concave part 244 and an engaging shaft body side engaging part, for example, a convex part 242 are formed. Thereby, after the treatment tool user uses, the operation sliding portion 222 is slid toward the distal end side, and the concave portion 244 and the convex portion 242 are engaged, so that the operation sliding portion 222 slides with respect to the shaft body 218. Since it can no longer be used, it will be understood that the treatment tool has been used once.
[0053]
Next, details of the sheath support portion 239 that supports the base end portion of the sheath 226 will be described with reference to the drawings.
[0054]
FIG. 9 is an enlarged view of the sheath support portion 239 shown in FIG. As shown in FIG. 9, the sheath attachment member 238 is provided with an opening that opens from the base end thereof, and the sheath caulking portion 236 is accommodated in the opening. The opening constitutes a wall portion 231 and a side wall portion 237 on one side in the axial direction of the sheath caulking housing portion 240. The open end of the sheath attachment member 238 is in contact with the wall that forms the attachment hole 233 at the tip of the shaft body 218, and this wall constitutes the wall portion 241 on the other side in the axial direction of the sheath caulking housing portion 240. Thus, the axial direction of the sheath caulking portion 236 is supported by the wall portion 231 of the sheath attachment member 238 and the wall portion 241 of the shaft body 218 constituting the sheath caulking housing portion 240.
[0055]
A female screw portion 252 is formed on the inner surface of the mounting hole 233 of the shaft body 218. A female screw escape portion 248 is formed on the base side of the female screw portion 252 (the base end side of the operation portion 214). The female screw escape portion 248 is formed by providing a notch along the inner periphery inside the mounting hole 233 at the tip of the shaft body 218.
[0056]
On the other hand, a male thread portion 250 is formed on the outer surface of the end portion of the sheath attachment member 238 on the shaft body 218 side. The male screw portion 250 is screwed to a female screw portion 252 provided at the tip of the shaft body 218. A male screw escape portion 246 is formed on the base side of the male screw portion 250 (the tip side of the operation portion 214). The male screw escape portion 246 is formed by providing a notch along the outer periphery of the sheath attachment member 238.
[0057]
In this way, the sheath attachment member 238 can be easily attached to the shaft body 218 in the axial direction by screwing the distal end portion of the shaft body 218 and the sheath attachment member 238.
[0058]
The sheath support portion 239 of the present embodiment is provided with a weak portion configured such that the operation sliding portion 222 is broken when a force exceeding the normal opening / closing operation range of the forceps portion 228 is applied. In the present embodiment, for example, one of the male screw escape portion 246 and the female screw escape portion 248 is set as a fragile portion.
[0059]
That is, the weakened portion in the present embodiment reduces the thickness of the portion where the male screw escaping portion 246 or the female screw flank portion 248 is formed, and increases the strength with respect to the axial direction of this portion (the forward / backward direction of the operation sliding portion 222). It is formed by lowering.
[0060]
The thickness of the part where the male screw escape portion 246 or the female screw escape portion 248 is formed is set to have the following fragility. That is, when the operation sliding portion 222 is further moved to the distal end side outside the normal opening / closing operation range of the forceps portion 228, the wall portion 231 on the distal end side of the sheath caulking housing portion 240 is pressed by the sheath caulking portion 236.
[0061]
Therefore, in this embodiment, the wall 231 on the distal end side of the sheath caulking housing portion 240 is pressed by the sheath caulking portion 236 so that the male screw escape portion 246 or the female screw escape portion 248 is damaged. The weak part is formed.
[0062]
As a result, the male screw escape portion 246 or the female screw portion escape portion 248 is damaged by moving the operation slide portion 222 outside the normal opening / closing operation range of the forceps portion 228, and therefore the biopsy forceps 212 cannot be reused. .
[0063]
In this embodiment, in order to prevent the male screw portion 250 and the female screw portion 252 from being damaged before the male screw escaping portion 246 or the female screw escaping portion 248 is damaged, the axial direction of the male screw portion 250 and the female screw portion 252 (operation The strength of the wire 224 in the forward / backward direction) needs to be greater than the strength in the axial direction of the male screw escape portion 246 and the female screw escape portion 248.
[0064]
Next, a modified example of the configuration of the sheath support portion 239 will be described with reference to the drawings. In the example shown in FIG. 9, the case where the sheath caulking portion 236 is attached to the sheath attachment member 238 has been described. FIG. 10 shows a configuration example in the case where the sheath caulking portion 236 is provided at the distal end portion of the shaft body 218.
[0065]
The sheath support part 339 in the modification shown in FIG. 10 is configured as follows. A step portion 351 having a diameter smaller than the outer diameter of the shaft body 318 is formed at the distal end portion of the shaft body 318 in the operation unit 214. In this step portion 351, an opening having an opening on the tip side is provided, and a sheath caulking portion 336 is attached to this opening. The side wall and the axial wall constituting the opening in the step portion 351 of the shaft body 318 constitute the side wall portion 337 of the sheath caulking housing portion 340 and the other wall 341 in the axial direction, respectively.
[0066]
The open end of the step portion 351 of the shaft body 318 is in contact with the wall constituting the attachment hole 333 of the sheath attachment member 338, and this wall constitutes the wall portion 331 on one side in the axial direction of the sheath caulking accommodation portion 340. . Thus, the axial direction of the sheath caulking portion 336 is supported by the wall portion 331 of the sheath attachment member 338 and the wall portion 341 of the shaft body 318 constituting the sheath caulking housing portion 340.
[0067]
A mounting hole 333 is provided in the end of the sheath mounting member 338 on the shaft body 318 side so as to contact the outer side surface of the step portion 351 of the shaft body 318. A female screw portion 352 is formed on the inner side surface of the mounting hole 333. A female screw escape portion 348 is formed on the base side of the female screw portion 352 (the front end side of the operation portion 214). The female screw escape portion 348 is formed by providing a notch along the inner periphery of the sheath attachment member 338.
[0068]
A male thread 350 is formed on the outer surface of the step 351. A male screw escape portion 346 is formed on the base side of the male screw portion 350 (the base end side of the operation portion 214). The male screw escape portion 346 is formed by providing a notch along the outer periphery of the step portion 351 of the shaft body 318. Even in this case, the sheath attaching member 338 can be easily attached to the shaft body 318 in the axial direction as in the case shown in FIG.
[0069]
The sheath support 339 shown in FIG. 10 is provided with a fragile portion configured such that the operation sliding portion 222 is broken when a force exceeding the normal opening / closing operation range of the forceps portion 228 is applied. In this modification, for example, any one of the male screw escape portion 346 and the female screw escape portion 348 is set as a fragile portion.
[0070]
In other words, the weakened portion in this modified example has a reduced thickness in the portion where the male screw escape portion 346 or the female screw escape portion 348 is formed, and the strength of this portion in the axial direction (the forward and backward direction of the operation sliding portion 222) is reduced. To form.
[0071]
The thickness of the part where the male screw escape portion 346 or the female screw escape portion 348 is formed is set to have the following fragility. That is, also in this modified example, as in the embodiment shown in FIG. 9, when the operation sliding part 222 is further moved to the distal end side outside the normal opening / closing operation range of the forceps part 228, the sheath caulking part 336 causes the sheath caulking accommodation part 340 The fragile portion is formed so that the male screw escape portion 346 or the female screw escape portion 348 is fragile to the extent that the wall portion 331 on the distal end side is pressed.
[0072]
As a result, the male screw escape portion 346 or the female screw escape portion 348 is damaged by moving the operation sliding portion 222 out of the normal opening / closing operation range of the forceps portion 228, so that the biopsy forceps 212 cannot be reused.
[0073]
Also in this modified example, in order to prevent the male screw portion 350 or the female screw portion 352 from being damaged before the male screw escaping portion 346 or the female screw escaping portion 348 is broken, The strength of the wire 324 in the advancing / retreating direction) needs to be greater than the strength of the male screw escape portion 346 and the female screw relief portion 348 in the axial direction.
[0074]
Next, the operation of the endoscope treatment tool of this embodiment will be described with reference to the drawings. FIG. 11 is an explanatory diagram of the operation of the biopsy forceps 212 of the present embodiment. In the drawing, the vicinity of the sheath support portion 239 is partially shown in a sectional view.
[0075]
In the present embodiment, as in the first embodiment, when closing the forceps portion 228, as shown in FIG. 11A, the operation sliding portion 222 is moved to the finger hooking portion 220 side. Further, when opening the forceps portion 228, as shown in FIG. 11B, the operation sliding portion 222 is moved to the insertion portion 216 side. Therefore, as in the first embodiment, during a normal opening / closing operation of the forceps portion 228, a stronger force acts in the direction in which the forceps portion 228 is closed, that is, the direction in which the operation sliding portion 222 is slid toward the proximal end side. Probability is high.
[0076]
Therefore, in this embodiment, after using the biopsy forceps 212, as shown in FIG. 11C, the direction opposite to the direction in which a strong force is applied, that is, the operation sliding portion 222 is operated to open and close the forceps portion 228. When it is further moved to the insertion portion 216 side that is out of the range, the wall portion 231 a on the distal end side of the sheath caulking housing portion 240 provided in the sheath attachment member 238 is pressed by the sheath caulking portion 236. When the wall portion 231a is pressed, the male screw escape portion 246 serving as a fragile portion is broken, and the sheath attachment member 238 on the distal end side comes out from the male screw escape portion 246.
[0077]
In the present embodiment, as in the first embodiment, the forceps 228 can be closed by moving the operation sliding portion 222 to the proximal end side even after the male screw escape portion 246 serving as the fragile portion is damaged. However, even if the operation sliding portion 222 is moved again to the insertion portion 216 side, the sheath attachment member 238 on the distal end side falls out from the male screw escape portion 246, and the sheath caulking portion 236 becomes the wall portion 231a on the distal end side of the sheath caulking housing portion 240. Therefore, the forceps 228 cannot be opened. This makes it impossible for the user to open and close the biopsy forceps 212 again. As a result, the biopsy forceps 212 once used can be prevented from being reused.
[0078]
In addition, in the present embodiment, as described above, the sheath attaching member 238 on the distal end side comes off from the male screw escape portion 246 by moving the operation sliding portion 222 to the distal end side outside the opening / closing operation range of the forceps portion 228. Therefore, it can be easily determined whether or not the biopsy forceps 212 has been used. For this reason, the misuse of the used treatment tool can be prevented beforehand. Therefore, in the second embodiment, whether or not the biopsy forceps 212 has been used without forming the above-described operation sliding portion side engaging portion such as the concave portion 244 and the shaft body side engaging portion such as the convex portion 242. Can be easily determined.
[0079]
In this embodiment, since the male screw escape portion 246 or the female screw escape portion 248 is a weak portion, the internal screw escape portion 248 is moved first by moving the operation sliding portion 222 outside the normal opening / closing operation range of the forceps portion 228. It can be damaged. At this time, the shaft body 218 and the sheath attachment member 238 on the distal end side from the female screw escape portion 248 are simultaneously withdrawn, making it impossible to open and close the biopsy forceps 212 again.
[0080]
As mentioned above, although preferred embodiment of this invention was described referring an accompanying drawing, this invention is not limited to this example. It will be obvious to those skilled in the art that various changes or modifications can be conceived within the scope of the technical idea described in the claims, and these are naturally within the technical scope of the present invention. It is understood that it belongs.
[0081]
For example, in the first and second embodiments of the present invention, the biopsy forceps of the endoscope treatment tool are taken up, but it is the same as the biopsy forceps composed of the operation part and the insertion part. An endoscopic treatment instrument such as a grasping forceps having a different configuration can also be used as a single-use treatment instrument that can be similarly prevented from being reused by adopting the same configuration and operation as the present embodiment. .
[0082]
Further, in the first and second embodiments of the present invention, the treatment tool that slides the operation sliding portion with respect to the shaft body by applying a stronger force in the closing direction of the forceps portion is taken up. In the treatment instrument that applies a stronger force in the direction of opening the forceps during the opening / closing operation, the same effect can be obtained by providing the weakened portion on the distal end side of the wire support portion.
[0083]
Furthermore, in the first and second embodiments, the weakly fragile portion is provided in either the wire support portion or the sheath support portion, but the fragile portion is provided in both the wire support portion and the sheath support portion. May be. At this time, it is preferable that the fragile portion of the sheath support portion is more fragile so that it can be easily used after the fragile portion is broken.
[0084]
【The invention's effect】
As described above, according to the present invention, the fragile portion provided in the wire support portion or the sheath support portion is damaged after use, thereby making it impossible to reuse the used single-use treatment instrument. Therefore, it is possible to prevent the occurrence of an accident such as infection or damage to the treatment tool due to the reuse of the used treatment tool.
[Brief description of the drawings]
FIG. 1 is a schematic configuration diagram of an entire endoscope.
FIG. 2 is an overall configuration diagram of an endoscope treatment tool.
FIG. 3 is a partial cross-sectional view illustrating an internal configuration of an operation unit of the endoscope treatment tool according to the first embodiment.
4 is an enlarged view of a portion A in FIG. 3;
FIG. 5 is an operation explanatory diagram of the endoscope treatment tool according to the first embodiment.
FIG. 6 is another modification of the fragile portion provided in the endoscope treatment tool according to the first embodiment.
FIG. 7 is another modification of the fragile portion provided in the endoscope treatment tool according to the first embodiment.
FIG. 8 is a partial cross-sectional view illustrating an internal configuration of an operation unit of the endoscope treatment tool according to the second embodiment.
FIG. 9 is an enlarged view of a portion B in FIG.
FIG. 10 is another modification of the fragile portion provided in the endoscope treatment tool according to the second embodiment.
FIG. 11 is an operation explanatory diagram of the endoscope treatment tool according to the second embodiment.
[Explanation of symbols]
100 Endoscope
102 Insertion part
104 Operation unit
106 Universal cord part
108 Treatment instrument insertion channel
110 Treatment tool insertion port
112,212 Biopsy forceps
114, 214 operation unit
116, 216 insertion part
118, 218, 318 Shaft
120, 220 finger rest
122,222 Operation sliding part
124,224,324 Operation wire
126,226,326 sheath
128,228 Forceps
130,230 slit
132,232 Wire caulking section
134,234 Wire caulking accommodation part
135,235 Wire support
136, 236, 336 Shikasukame Department
138, 238, 338 Sheath mounting member
139, 239, 339 Sheath support
140, 240, 340 Seed Squash Retainer
142,242 Convex
144,244 Recess
146 Groove
148 Notch
150 Support member
231, 241, 331, 341 Wall
233,333 Mounting hole
237, 337 Side wall
246,346 Male thread relief
248, 348 female thread relief
250,350 Male thread
252 and 352 internal thread
351 Step

Claims

A forceps portion is provided at the distal end portion of the sheath constituting the insertion portion, and the forceps portion can be opened and closed by moving the wire forward and backward with respect to the sheath by the operation portion provided at the proximal end portion of the insertion portion. In endoscopic treatment tools;
The operation portion includes a sheath support portion that supports a proximal end portion of the sheath, and a wire support portion that supports the wire so that the wire can be moved forward and backward with respect to the sheath support portion.
A treatment instrument for an endoscope, wherein a fragile portion that is easily damaged is provided on either the wire support portion or the sheath support portion.

The fragile portion has a fragility to such an extent that the fragile portion is damaged when a force exceeding the range of opening and closing operation of the forceps portion is applied to any of the advancing and retreating directions of the wire support portion. The treatment instrument for endoscope as described.

When the force exceeding the range of the opening / closing operation of the forceps portion is applied in the direction opposite to the direction in which a stronger force is applied during the opening / closing operation of the forceps portion among the advancement / retraction directions of the wire support portion, The endoscopic treatment instrument according to claim 1, wherein the endoscopic treatment tool is vulnerable to breakage.

The wire support portion has wall portions that respectively support the forward and backward directions of the wire caulking portion provided at the proximal end portion of the wire,
The said weak part is formed in the wall part on the opposite side to the direction where stronger force acts at the time of opening / closing operation | movement of the forceps part among the said wall parts, The 1-3 characterized by the above-mentioned. The endoscope treatment tool according to any one of the above.

The weakened portion has a wall portion on the opposite direction side of the wall portion provided on the wire support portion, the wall portion on the opposite direction side of the wall portion on the direction side where a stronger force acts when the forceps portion is opened and closed. The endoscopic treatment tool according to claim 4, wherein the endoscopic treatment tool is formed by thinning.

The wire support portion includes a wall portion for supporting the advancing and retreating directions of the wire caulking portion provided at the base end portion of the wire, and a side wall portion that is connected to the wall portion and covers the outer peripheral surface of the wire caulking portion. ,
The fragile portion is formed by providing a notch along the outer peripheral surface of the side wall portion of the wire support portion and weakening the strength in the advancing / retreating direction of a part of the side wall portion. The treatment tool for endoscopes in any one of -3.

The sheath support portion includes a wall portion that supports the forward and backward directions of the sheath caulking portion provided at the base end portion of the sheath, and a side wall that is connected to at least one of the wall portions and covers the outer peripheral surface of the sheath caulking portion And
The endoscopic treatment tool according to any one of claims 1 to 3, wherein the fragile portion is formed in the side wall portion.

The fragile portion is formed by providing a notch on the outer peripheral surface of the side wall portion of the sheath support portion to weaken the advancing / retreating direction strength of a part of the side wall portion. The treatment instrument for endoscope as described.

The operation portion includes the shaft body provided with the sheath support portion, and an operation slide portion provided with the wire support portion and slidable in the advancing and retreating direction with respect to the shaft body,
The sliding surface of the shaft body with respect to the operation sliding portion includes an operation sliding portion side engagement formed on the operation sliding portion when the operation sliding portion is slid at least beyond the position where the fragile portion is damaged. The endoscope treatment tool according to any one of claims 1 to 6, wherein the shaft body side engaging portion that engages with the joint portion is formed.

The shaft body side engaging portion is located at a position that exceeds at least the opening / closing operation range of the forceps portion in a range of sliding operation of the operation sliding portion of the sliding surface of the shaft body with the operation sliding portion. The endoscopic treatment tool according to claim 9, which is formed.

On the sliding surface of the shaft body with the operation sliding portion, a convex portion is formed as the shaft body side engaging portion,
The endoscope treatment tool according to claim 9 or 10, wherein a concave portion is formed as a sliding portion on the side of the operation sliding portion on a sliding surface of the operation sliding portion with the shaft body.