JP4349703B2 - Endoscopic treatment tool - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an endoscope treatment instrument that is used by being inserted into and removed from an endoscope treatment instrument insertion channel.
[0002]
[Prior art]
An endoscopic treatment instrument such as an endoscopic biopsy forceps has a pair of distal end treatment pieces provided at the distal end of the sheath inserted into and removed from the endoscopic treatment instrument insertion channel. It can be opened and closed like a bowl by remote control.
[0003]
Such endoscopic treatment tools include a double-open type that opens and closes at the same movement angle in a direction in which a pair of distal treatment pieces are opposite to each other, and only one distal treatment piece opens and closes and the other distal tip There is a fixed single-opening treatment piece.
[0004]
However, the single-open type has a sense of incongruity because only one of the tip treatment pieces operates when the affected mucous membrane is sandwiched between a pair of tip treatment pieces, and the double-open type is widely used. Yes.
[0005]
[Problems to be solved by the invention]
If the affected area of the treatment target on the mucosal surface or the like in the body cavity is located in front of the treatment tool protruding from the treatment tool insertion channel of the endoscope, the conventional double-opening treatment tool as described above is used. This makes it possible to easily perform endoscopic treatment by easily sandwiching the affected mucous membrane with a pair of tip treatment pieces.
[0006]
However, when the distal treatment piece of the endoscope treatment tool can only be aimed at an oblique direction with respect to the affected area (in reality, there are very many cases in this case), the affected area with a pair of distal treatment pieces In many cases, it is difficult to sandwich the mucous membrane and endoscopic treatment cannot be performed smoothly.
[0007]
Therefore, the inventor of the present invention has invented a treatment instrument for an endoscope using a link mechanism that operates a pair of distal treatment pieces so that the opening angles are different from each other, and has applied for a patent (Japanese Patent Laid-Open No. 11-216146). issue).
[0008]
However, there is a limit in making the opening angle of the pair of distal treatment pieces different by the link mechanism, and this corresponds to the case where the opening direction of the pair of distal treatment pieces (ie, the center direction of the opening) is desired to be directed to the side. Was difficult.
[0009]
Accordingly, the present invention provides an endoscopic treatment tool that can easily and safely perform endoscopic treatment by sandwiching an affected tissue or the like located obliquely between a pair of distal treatment pieces. With the goal.
[0010]
[Means for Solving the Problems]
In order to achieve the above object, an endoscope treatment tool according to the present invention is a pair of tip treatments that are disposed in a hook-like manner so as to be freely opened and closed at a tip portion of a sheath that is inserted into and removed from a treatment tool insertion channel of an endoscope. In an endoscopic treatment tool in which a piece is opened and closed by an operation wire inserted in a sheath so as to be able to advance and retreat, the maximum opening angle of one of the pair of distal treatment pieces is forcibly set. Opening restricting means for restricting and wire moving means for causing the operation wire to move by a certain range with respect to one of the distal treatment pieces are provided.
[0011]
The operation wire may be divided into two wires that drive the pair of distal treatment pieces separately at least at the distal end portion.
Further, the opening restricting means is formed by a slot and a pin moving in the slot, one of which is interlocked with one tip treatment piece and the other is fixedly provided with respect to the tip of the sheath. May be.
[0012]
Moreover, the long groove | channel which the front-end | tip of an operation wire engages slidably is formed in the link member for opening and closing one front-end | tip treatment piece, and the wire floating means may be formed by it.
[0013]
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 an endoscopic biopsy forceps to which the present invention is applied. FIG. 1 is a side sectional view and FIG. 2 is a plan sectional view.
[0014]
A distal end body 1 is connected and fixed to the distal end of a flexible sheath 2 made of, for example, a tightly wound coil pipe, which is inserted into and removed from a treatment instrument insertion channel of an endoscope (not shown). The distal end main body 1 is configured by integrally joining a front frame portion 1 a in which a large slit 3 is formed from the front side and an annular portion 1 b fixed to the sheath 2.
[0015]
A support shaft 4 is attached to the tip body 1 so as to cross the vicinity of the tip of the slit 3, and a pair of forceps cups 5 a and 5 b (tip treatment pieces) are rotatably supported on the support shaft 4. Yes.
[0016]
In the slit 3, a pair of links 11 and 12 for opening and closing the pair of forceps cups 5a and 5b are disposed. The links 11 and 12 are formed integrally and continuously with the forceps cups 5a and 5b, respectively, and rotate around the support shaft 4.
[0017]
Of these, the first link 11 integrated with the first forceps cup 5 a is formed with a short arc-shaped groove 7 a centering on the support shaft 4, and pins 7 b having both ends fixed to the distal end body 1. It passes through the slot 7a.
[0018]
Therefore, the rotation angle of the first link 11 and the first forceps cup 5a integrated with the first link 11 is restricted to a range where the pins 7b collide with both ends of the slot 7a. Specifically, the opening angle of the first forceps cup 5a is regulated within a range of 5 ° from the closed state, for example.
[0019]
Thus, the opening restricting means 7 for forcibly restricting the maximum opening angle of the first forceps cup 5a is constituted by the slot 7a and the pin 7b. On the other hand, the second forceps cup 5b side can operate without any restriction in the range from the closed state to the fully open state of, for example, 75 °.
[0020]
An operation wire 6 is inserted through the entire length of the sheath 2 so as to be movable back and forth in the axial direction, and is advanced and retracted by an operation from a proximal-side operation unit (not shown).
[0021]
The operation wire 6 is configured by passing two wires 6a and 6b through the covering tube 6c, and the two wires 6a and 6b are fixed to and fixed to the fixing base 6d in the vicinity of the tip. The two wires 6a and 6b have appropriate rigidity.
[0022]
Two wires 6a and 6b are arranged separately on the further side, and the tip portions of the first wire 6a and the second wire 6b are respectively connected to the first link 11 via the eyelet 6e. The second link 12 is rotatably connected to the second link 12 so as not to come out.
[0023]
Of these, the second wire 6 b is connected to a round hole formed in the second link 12. Therefore, the second forceps cup 5b integrated with the second link 12 follows the forward / backward movement of the second wire 6b, and rotates around the support shaft 4.
[0024]
On the other hand, the first link 11 has a long groove 8 that is elongated in the front-rear direction. The long groove 8 is formed so that the tip portion of the first wire 6a can slide along the longitudinal direction thereof, and is formed to have a length slightly shorter than the entire stroke length of the first wire 6a. .
[0025]
In the endoscope treatment tool of the embodiment configured as described above, the first forceps cup 5a and the second forceps are shown in FIG. 3 in a state where the operation wire 6 is pulled to the full side. The cup 5b is closed in contact with each other on the extension of the axis of the sheath 2.
[0026]
When the operation wire 6 is pushed from the proximal side to the distal end side, as shown in FIG. 4, the second forceps cup 5b opens to a full extent up to 75 °, for example. However, since the tip of the first wire 6a moves along the long groove 8, the first forceps cup 5a does not operate at all, and the tip of the first wire 6a hits the tip of the long groove 8. The first forceps cup 5a begins to open.
[0027]
Then, the first forceps cup 5a is opened only within a range in which the pin 7b can move in the slot 7a, and further opening of, for example, 5 ° or more is restricted by the opening restricting means 7 including the slot 7a and the pin 7b. .
[0028]
Therefore, in the state shown in FIG. 4 in which the pair of forceps cups 5a and 5b is opened to the maximum, the center direction of the pair of forceps cups 5a and 5b that is opened to the maximum is significantly oblique to the front (35 °) As a result, a tissue specimen can be collected by easily sandwiching the affected tissue or the like located obliquely between the pair of forceps cups 5a and 5b.
[0029]
In addition, this invention is not limited to the said embodiment, For example, the slot 7a may be provided in the front-end | tip main body 1, and the pin 7b may be provided in the link 11 side. The present invention is not limited to the endoscopic biopsy forceps but can be applied to grasping forceps and other various endoscopic treatment tools.
[0030]
【The invention's effect】
According to the present invention, the opening restricting means for forcibly restricting the maximum opening angle of one tip treatment piece of the pair of tip treatment pieces, and the operation wire is allowed to float within a certain range with respect to the one tip treatment piece. By providing the wire moving means, the center direction of the pair of distal treatment pieces that are opened to the maximum can be greatly directed to the oblique side, so that even when the affected part to be treated exists on the oblique side. The pair of tip treatment pieces can be easily and smoothly endoscopically directed toward the affected part, and is easy to use because of the double-opening type.
[Brief description of the drawings]
FIG. 1 is a side sectional view of a distal end portion of an endoscope treatment tool according to an embodiment of the present invention.
FIG. 2 is a plan sectional view of the distal end portion of the endoscope treatment tool according to the embodiment of the present invention.
FIG. 3 is a side sectional view of the distal end portion of the endoscope treatment tool according to the embodiment of the present invention in a state where the distal treatment piece is closed.
FIG. 4 is a side sectional view of the distal end portion of the endoscope treatment tool according to the embodiment of the present invention in a state where the distal treatment piece is opened.
[Explanation of symbols]
2 Sheath 5a, 5b Forceps cup (tip treatment piece)
6 Operation wires 6a, 6b Wire 7 Opening restricting means 7a Groove hole (opening restricting means)
7b pin (opening restriction means)
8 Long groove (wire moving means)

Claims (4)

A pair of distal treatment pieces, which are arranged to be opened and closed in a hook-like manner at the distal end portion of the sheath that is inserted into and removed from the treatment instrument insertion channel of the endoscope, are opened and closed by an operation wire that is inserted into the sheath so as to advance and retract. In the endoscopic treatment tool as described above,
An opening restricting means for forcibly restricting a maximum opening angle of one of the pair of distal treatment pieces, and a wire moving means for causing the operation wire to move within a certain range with respect to the one distal treatment piece. And a treatment instrument for an endoscope. The endoscopic treatment tool according to claim 1, wherein the operation wire is divided into two wires for separately driving the pair of distal treatment pieces at least at a distal end portion. The opening restricting means is formed by a slot and a pin moving in the slot, one of which is interlocked with the one distal treatment piece and the other is fixedly provided with respect to the distal end of the sheath. The endoscope treatment tool according to claim 1 or 2. 2. A long groove in which a distal end of the operation wire is slidably engaged is formed in a link member for opening and closing the one distal treatment piece, thereby forming the wire floating means. Endoscopic treatment instrument according to 2 or 3.

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