JP4459692B2 - Bipolar high-frequency treatment instrument for endoscope - Google Patents

Description

  The present invention relates to a bipolar high-frequency treatment instrument for an endoscope in which a pair of tip electrodes that are electrically insulated from each other are disposed at the tip of a flexible sheath.

In a bipolar high-frequency treatment instrument for an endoscope, generally, a pair of tip electrodes that are electrically insulated from each other are movably disposed at the tip of a flexible sheath, and the flexible sheath is used to operate the pair of tip electrodes. An operation wire, which is inserted through the entire length so as to be movable back and forth in the axial direction, is formed by a pair of electrically insulated wires for supplying a high-frequency current to each tip electrode. That is, a pair of conducting wires also serves as an operation wire (for example, Patent Documents 1 and 2).
JP 2002-253570 A JP2003-299668

  FIG. 6 is a cross-sectional view in the direction perpendicular to the axis of the flexible sheath 90 in the conventional bipolar high-frequency treatment instrument for endoscope as described above. Although the tube 92 is covered, the flexible space 90 occupies a large proportion of the other marginal space 100.

  Therefore, when the conducting wire 91 (and the insulating tube 92 covered therewith) is pushed in as an operation wire in the axial direction from the hand side, the conducting wire 91 snakes in the marginal space 100 in the flexible sheath 90 due to meandering. The movement may be absorbed in the middle, and the tip electrode may become insufficiently operated.

  Therefore, the present invention provides a bipolar high-frequency treatment instrument for an endoscope in which a pair of conducting wires inserted and arranged in a flexible sheath is used as an operation wire in order to pass a high-frequency current to the pair of tip electrodes. An object of the present invention is to ensure that the push-in motion is well transmitted from the hand side to the tip side so that the tip electrode operates well.

  In order to achieve the above object, the bipolar high-frequency treatment instrument for an endoscope of the present invention has a pair of tip electrodes electrically insulated from each other at the tip of a flexible sheath, and operates the pair of tip electrodes. In order for the endoscope, the operation wires, which are inserted through the entire length of the flexible sheath so as to be movable back and forth in the axial direction, are a pair of electrically insulated conductors for supplying a high-frequency current to each tip electrode. In the bipolar high-frequency treatment instrument, a dummy tube made of an electrically insulating tube-like member for filling an extra space in the flexible sheath is inserted and disposed in parallel with the pair of conductors in the flexible sheath. When the lead wire is advanced and retracted from the proximal end side, the dummy tube is advanced and retracted in the axial direction in the flexible sheath.

  The pair of conductors may be covered with an electrically insulating insulating tube, and the same insulating tube may be used as a dummy tube. In this case, the outer diameter of the insulating tube is a flexible sheath. It is good to be in the range of 0.41 to 0.45 times the inner diameter dimension.

  In addition, the pair of conductors are integrally bundled by a bundling member at a position near the distal end in the flexible tube, and the dummy tube is disposed between the rear position of the bundling member and the vicinity of the proximal end of the flexible tube. May be.

  According to the present invention, a dummy tube made of an electrically insulating tube-like member for filling a margin space in the flexible sheath is inserted and arranged in parallel with the pair of conductors in the flexible sheath, When the lead wire is moved back and forth from the proximal end side, the dummy tube is moved back and forth in the axial direction in the flexible sheath, so that the push-in motion of the operation wire is not absorbed in the flexible sheath and is close to the hand. The tip electrode works well with good transmission from the side to the tip side.

  A pair of tip electrodes that are electrically insulated from each other are movably disposed at the tip of the flexible sheath, and are inserted through the entire length of the flexible sheath so as to be able to advance and retract in the axial direction in order to operate the pair of tip electrodes. In a bipolar high-frequency treatment instrument for an endoscope, in which a wire is a pair of electrically insulated conductors for supplying a high-frequency current to each tip electrode, an extra space in the flexible sheath is provided in the flexible sheath. A dummy tube made of an electrically insulating tube-like member is embedded in parallel with the pair of conductors, and when the pair of conductors is advanced and retracted from the proximal end, the dummy tube is moved into the flexible sheath. In the direction of the axis, it is advanced and retracted.

Embodiments of the present invention will be described with reference to the drawings.
FIG. 2 shows the entire configuration of the bipolar high-frequency treatment instrument for endoscope, and FIG. 3 shows the configuration near the tip.

  Reference numeral 1 denotes an electrically insulating flexible sheath formed by, for example, an ethylene tetrafluoride resin tube that can be inserted into and removed from a treatment instrument insertion channel of an endoscope (not shown). An electrically insulating tip support body 2 made of ceramics, heat resistant plastic or the like is attached.

  A pair of bowl-shaped tip electrodes 3A and 3B made of, for example, stainless steel or the like, which are electrically conductive, for example, are electrically insulated from each other as shown in FIG. , 4B are attached to be rotatable.

  The arms 5A, 5B formed so as to extend integrally from the respective tip electrodes 3A, 3B to the rear of the support shafts 4A, 4B are disposed in the slits 2a formed in the tip support body 2. Thus, the distal ends of a pair of conducting wires 6A and 6B that are inserted into the flexible sheath 1 so as to be movable back and forth in the axial direction are connected to the arms 5A and 5B.

  As shown in FIG. 2, the operation unit 20 connected to the proximal side proximal end of the flexible sheath 1 is not shown in the movable finger hook 22 slidably attached to the operation unit main body 21. A positive / negative bipolar type connection terminal 23 for connecting the high-frequency power cord is disposed, and the base ends of the pair of conductors 6A and 6B are connected to the connection terminal 23.

  With such a configuration, the lead wires 6A and 6B move back and forth within the flexible sheath 1 by moving the movable finger 22 forward and backward, thereby opening and closing the tip electrodes 3A and 3B in a hook shape. In FIG. 3, a state in which the tip electrodes 3A and 3B are opened is shown by a two-dot chain line.

  In this way, the pair of conductors 6A and 6B also serves as an operation wire for opening and closing the tip electrodes 3A and 3B. However, the tip electrodes 3A and 3B are connected from the connection terminal 23 via the pair of conductors 6A and 6B. The pair of conductors 6A and 6B are connected to the tip electrodes 3A and 3B in a state of being electrically insulated from each other so that a high-frequency current can be supplied without leakage.

  3A1 and 7A2 shown in FIG. 3 are electrically insulating insulating tubes covered with one conducting wire 6A, and 7B1 and 7B2 are electrically insulating insulating tubes covered with the other conducting wire 6B. 6A and the other conducting wire 6B are not in direct contact with each other.

  The pair of conductors 6A and 6B are bundled together with insulating tubes 7A1 and 7B1 in the vicinity of the distal end by a bundling member 8 made of an electrically insulating member, and the pair of conductors 6A and 6B pass through the bundling member 8. A pair of parallel through holes 9A and 9B are formed in the axial direction.

  Then, on the side adjacent to the front side of the binding member 8, only one of the pair of conductors 6A and 6B is covered with the insulating tube 7A1, and the other conductor 6B arranged side by side is covered with the insulating tube 7A1. It is exposed in the flexible sheath 1.

  In addition, on the side adjacent to the rear side of the binding member 8, only the other conductor 6 </ b> B is covered with the insulating tube 7 </ b> B <b> 1, and the one conductor 6 </ b> A arranged side by side is exposed in the flexible sheath 1. .

  In this way, the insulating tube 7A1 covered with the one conducting wire 6A on the front side of the binding member 8 and the insulating tube 7B1 covered with the other conducting wire 6B on the rear side of the binding member 8 are respectively connected to the through holes 9A. , 9B, large diameter portions 10A, 10B are formed in the respective through holes 9A, 9B.

  In each of the large diameter portions 10A and 10B, the insulating tubes 7A1 and 7B1 are bonded and fixed to the binding member 8, and in the other portions of the through holes 9A and 9B, the conductive wires 6A and 6B are directly connected to the binding member 8. Bonded and fixed.

  Therefore, the conducting wires 6A and 6B and the insulating tubes 7A1 and 7B1 can be reliably bonded and fixed to the binding member 8 by an extremely easy assembly operation, and a pair of conducting wires 6A and 6B as operation wires can be obtained. It is possible to advance and retreat uniformly so that the movement does not fall apart at the tip portion.

  Further, in order to ensure the electrical insulation between the pair of conductors 6A and 6B behind the binding member 8, the conductors 6A and 6B are covered with long insulating tubes 7A2 and 7B2 that reach the operation unit 20, respectively.

  However, the insulating tubes 7A2, 7B2 reaching the operation unit 20 are considered in consideration of slippage between the insulation tubes 7A2, 7B2 reaching the operation unit 20 and the conducting wires 6A, 6B when the flexible sheath 1 is bent. A gap of about several millimeters is formed in the axial direction between the front end surface of the binding member 8 and the rear end surface of the binding member 8 (and the rear end surface of the insulating tube 7B1 fixed to the rear side of the binding member 8).

  Further, in the flexible sheath 1, it is also shown in FIG. 1 illustrating a cross section taken along line II in FIG. 3 in a range between the rear position of the binding member 8 and the vicinity of the proximal end of the flexible sheath 1. As shown, a dummy tube 17 made of an electrically insulating tube-shaped member for filling the marginal space 100 in the flexible sheath 1 is inserted and arranged in parallel with the pair of conductors 6A and 6B.

  As the dummy tube 17 of this embodiment, the same insulating tube as the insulating tubes 7A2 and 7B2 covered with the conducting wires 6A and 6B is used, and at an appropriate position (for example, near both ends of the dummy tube 17) They are fixedly bonded to each other (appropriate intermediate position or over the entire length of the dummy tube 17).

  The outer diameters of the dummy tube 17 and the insulating tubes 7A2 and 7B2 are set in a range of 0.41 to 0.45 times the inner diameter of the flexible sheath 1, and FIG. The case of 43 times is shown.

  Incidentally, FIGS. 4 and 5 show the cases of 0.40 times and 0.46 times. Below 0.40 times, the margin space 100 is too large, and the conductors 6A and 6B meander in the forward and backward movement. If it is 0.46 times or more, the marginal space 100 is too small, and the conducting wires 6A and 6B do not advance and retreat smoothly. Therefore, the range of 0.41 to 0.45 times is preferable.

  With such a configuration, when the pair of conductors 6A and 6B is operated to advance and retract from the operation unit 20 side, the dummy tube 17 smoothly advances and retracts in the axial direction with almost no meandering in the flexible sheath 1, The pushing motion of the pair of conducting wires 6A and 6B as the operation wires is well transmitted from the hand side to the tip side, and the tip electrodes 3A and 3B operate well.

  The present invention is not limited to the above embodiment. For example, the dummy tube 17 may be a tube having a size different from that of the insulating tubes 7A2 and 7B2, and the dummy tube 17 is placed in the flexible sheath 1. More than this may be inserted.

It is II sectional drawing in FIG. 3 of the bipolar type high frequency treatment tool for endoscopes of the Example of this invention. 1 is a side view showing an overall configuration of an endoscope bipolar high-frequency treatment instrument according to an embodiment of the present invention. It is side surface sectional drawing of the tip vicinity of the bipolar type high frequency treatment tool for endoscopes of the Example of this invention. It is sectional drawing corresponding to II sectional drawing in FIG. 3 which shows the out-of-range example of the range of invention of the bipolar type high frequency treatment tool for endoscopes of this invention. It is sectional drawing corresponding to II sectional drawing in FIG. 3 which shows the out-of-range example of the range of invention of the bipolar type high frequency treatment tool for endoscopes of this invention. It is sectional drawing in a cross section perpendicular | vertical with respect to the axis line of the conventional bipolar type high frequency treatment tool for endoscopes.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Flexible sheath 3A, 3B Tip electrode 6A, 6B Conductor 7A2, 7B2 Insulation tube which reaches an operation part 8 Bundling member 17 Dummy tube 100 Margin space

Claims (4)

A pair of tip electrodes, which are electrically insulated from each other, are movably disposed at the tip of the flexible sheath, and are inserted through the entire length of the flexible sheath so as to be movable back and forth in the axial direction in order to operate the pair of tip electrodes. In the bipolar high-frequency treatment instrument for endoscope, in which the operation wire is a pair of conductive wires electrically insulated from each other for supplying a high-frequency current to each tip electrode,
In the flexible sheath, a dummy tube made of an electrically insulating tube-like member for filling a margin space in the flexible sheath is inserted and arranged in parallel with the pair of conductors, and the pair of conductors is A bipolar high-frequency treatment instrument for an endoscope, wherein when the advancing / retreating operation is performed from the proximal end side, the dummy tube is advanced / retreated in the axial direction in the flexible sheath. The bipolar high-frequency treatment instrument for an endoscope according to claim 1, wherein the pair of conductive wires are each covered with an electrically insulating insulating tube, and the same insulating tube is used as the dummy tube. The bipolar high-frequency treatment instrument for endoscope according to claim 2, wherein the outer diameter of the insulating tube is in the range of 0.41 to 0.45 times the inner diameter of the flexible sheath. The pair of conductive wires are integrally bound by a binding member at a position in the vicinity of the distal end in the flexible tube, and the dummy tube is located between the rear position of the binding member and the vicinity of the proximal end of the flexible tube. The bipolar high-frequency treatment instrument for an endoscope according to claim 1, 2 or 3, which is disposed between the two.

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