JP4390510B2 - Endoscopic high-frequency snare - Google Patents

Description

  The present invention relates to an endoscopic high-frequency snare that is passed through a treatment instrument insertion channel of an endoscope and used for performing mucosal resection or the like.

In general, a high-frequency snare for an endoscope has an operation wire inserted through a flexible sheath so as to be movable back and forth in the axial direction, and a snare loop made of an elastic wire is connected to the tip of the operation wire. By moving the wire forward and backward in the axial direction, the wire enters and leaves the distal end of the flexible sheath, swells by its own elasticity outside the flexible sheath, and elastically deforms and narrows by being pulled into the flexible sheath. (For example, Patent Document 1).
JP 2000-83963 A

  In general, when performing mucosal resection endoscopically, if the target affected area is found by endoscopic observation, the marking is first performed on the mucosal surface of the contour of the area to be excised. A procedure is taken in which the inner mucous membrane surrounded by the incision is excised after the mucosal surface is incised in an annular shape.

  However, the conventional endoscopic high-frequency snare can only perform mucosal resection out of such treatments, and includes a treatment instrument for performing marking, a treatment instrument for performing mucosal incision, and a mucosal resection. Since it is necessary to replace and use the high-frequency snare for the endoscope, not only is the operation extremely complicated, but also the sterilization may become difficult due to the possibility of the spilling of the liquid every time the treatment tool is replaced. There was a problem.

  Therefore, the present invention provides a high-frequency endoscopic snare that can easily perform marking, mucosal incision, and mucosal resection continuously with a single treatment instrument when performing transendoscopic mucosal resection. For the purpose.

  In order to achieve the above object, an endoscope high-frequency snare according to the present invention has a conductive operation wire inserted and disposed in an electrically insulating flexible sheath so as to be movable back and forth in the axial direction. A snare loop made of a conductive elastic wire is connected to the tip, and the snare loop moves in and out of the tip of the flexible sheath by moving the operating wire forward and backward in the axial direction. In a high-frequency endoscope snare that bulges by its own elasticity and is elastically deformed and narrowed by being pulled into a flexible sheath, the elastic wire is bent to protrude sideways at the tip of the snare loop It is a thing.

  In addition, the elastic wire may be bent in a substantially L shape at the tip of the snare loop, or may be bent in a substantially J shape.

  According to the present invention, at the tip of the snare loop capable of supplying a high-frequency current, the elastic wire forming the snare loop is bent so as to protrude sideways, so that the marking treatment and the mucosal incision are performed by the tip bent portion. Since the treatment can be performed and the mucous membrane excision treatment can be performed by the snare loop, the marking, the mucosal incision, and the mucous membrane excision can be performed continuously and easily with one treatment tool.

  At the tip of the snare loop that can pass a high-frequency current, an elastic wire that forms the snare loop is bent into a substantially L shape or a substantially J shape so as to protrude sideways.

Embodiments of the present invention will be described with reference to the drawings.
1 and 2 show the distal end portion of the high-frequency snare for endoscope, FIG. 1 shows a state in which the snare loop 10 is swollen, and FIG. 2 shows a state in which the snare loop 10 is narrowed.

  In the endoscope high-frequency snare of this embodiment, for example, a stainless steel stranded wire or the like is placed in a flexible sheath 1 made of an electrically insulating flexible tube such as a tetrafluoroethylene resin tube. A highly conductive flexible operation wire 2 is inserted and arranged so as to be movable forward and backward in the axial direction.

  Two elastic wires 4 and 5 forming a snare loop 10 are connected to the distal end of the operation wire 2 via a metal connection pipe 3 and are connected to the proximal end of the flexible sheath 1. The snare loop 10 moves in and out of the distal end of the flexible sheath 1 by operating the operation wire 2 forward and backward in an operation section (not shown).

  As shown in FIG. 1, the snare loop 10 swells in a loop shape by its own elasticity when it is outside the flexible sheath 1, and is drawn into the flexible sheath 1 as shown in FIG. This causes elastic deformation and narrowing.

  Each of the elastic wires 4 and 5 forming the snare loop 10 is formed of, for example, a stranded wire obtained by twisting a plurality of stainless steel wires or a single wire, and a high-frequency current is passed through the operation wire 2 from the operation unit side. Can do.

  The rear end portions of the two elastic wires 4 and 5 constituting the snare loop 10 are arranged in parallel in the connection pipe 3, but the tip portions are arranged in parallel, for example, silver brazing, gold brazing Alternatively, they are joined together by laser spot welding or the like.

  And the most advanced part of one elastic wire 4 is bent by the substantially L shape, and protrudes short (for example, about 1-3 mm) toward the side. Reference numeral 6 denotes a distal end bending portion, and the distal end bending portion 6 may not be retracted into the flexible sheath 1.

The endoscope high-frequency snare according to the embodiment configured as described above observes the distal end portion projected from the treatment instrument insertion channel 11 of the endoscope 50 through the observation window 12 as shown in FIG. Three procedures of marking, mucosal dissection and mucosal resection can be performed in order.

  FIG. 3 shows the state of the marking treatment. A high-frequency current is applied only for a short time by bringing the tip of the tip bending portion 6 into point contact with the contour of the range where mucosal resection around the target affected part 100 is to be performed. Thereby, the marking 101 which consists of a dotted | punctate burn part can be formed.

  FIG. 4 shows a state of the subsequent mucosal incision treatment, and the distal end bending portion 6 is stabbed into the mucous membrane and moved along the marking 101 while energizing a high-frequency current. The mucosa is incised.

  FIG. 5 shows the state of the final mucosal resection treatment. The target affected area 100 in which the surrounding mucosa is incised is surrounded by the snare loop 10, and the snare loop 10 is drawn into the flexible sheath 1 and gradually narrowed. By applying a high-frequency current, the mucous membrane of the target affected area 100 can be easily excised.

  Note that the present invention is not limited to the above-described embodiment. For example, as shown in FIG. 6, the same effect as that of the above-described embodiment can be obtained even if the tip bent portion 6 is formed in a substantially J-shape or other shape. Can be obtained.

It is side surface sectional drawing of the state which the snare loop of the high frequency snare tip part for endoscopes of the 1st Example of this invention swelled. It is side surface sectional drawing of the state which the snare loop of the high frequency snare tip part for endoscopes of the 1st Example of this invention was narrowed. It is a perspective view which shows the state of the marking treatment of the high frequency snare for endoscopes of the 1st Example of this invention. It is a perspective view which shows the state of the mucosal incision treatment of the high frequency snare for endoscopes of the 1st Example of this invention. It is a perspective view which shows the state of the mucous membrane excision treatment of the high frequency snare for endoscopes of the 1st Example of this invention. It is side surface sectional drawing of the state which the snare loop of the high frequency snare tip part for endoscopes of the 2nd Example of this invention swelled.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Flexible sheath 2 Operation wire 4,5 Elastic wire 6 Bend part 10 Snare loop

Claims (3)

A conductive operation wire is inserted and disposed in an electrically insulating flexible sheath so as to be movable back and forth in the axial direction, and a snare loop made of a conductive elastic wire is connected to the tip of the operation wire. By moving forward and backward in the axial direction, the snare loop enters and exits the distal end of the flexible sheath, and the snare loop expands by its own elasticity outside the flexible sheath and is drawn into the flexible sheath. In a high-frequency endoscope snare that is elastically deformed and narrowed,
The snare loop is formed by binding two elastic wires at the distal end and the proximal end,
An endoscope high-frequency snare, wherein a tip end portion of only one of the two elastic wires is bent at a tip of the snare loop so as to protrude sideways. The high-frequency endoscope snare according to claim 1, wherein the elastic wire is bent in a substantially L shape at the tip of the snare loop. The high-frequency endoscope snare according to claim 1, wherein the elastic wire is bent in a substantially J shape at the tip of the snare loop.

Images