JP4468925B2 - Endoscopic treatment tool - Google Patents

Description

  The present invention relates to an endoscope treatment tool.

As a treatment instrument for an endoscope, a sheath, an operation wire that can be moved forward and backward in the sheath, a treatment portion connected to a distal end of the operation wire, and an operation portion for moving the operation wire forward and backward in the sheath are provided. Things have been proposed. For example, the treatment part serves as an electrode and is inserted into a body cavity through a channel of an endoscope, and a high-frequency current is applied to excise or coagulate the target part (see Patent Document 1). Has a pair of arm parts, and a target part is grasped by a pair of arm parts (refer to patent documents 2).
JP 2005-110661 A JP 05-42167 A

However, since the above-described conventional endoscope treatment tool is configured by integrally connecting an operation wire and a treatment portion separately prepared in advance, parts and manufacturing processes related to the connection are required.
The present invention has been made in view of the above circumstances, and provides an endoscopic treatment tool that can be easily assembled in a short time by reducing parts and processes involved in manufacturing. Objective.

The present invention employs the following means in order to solve the above problems.
An endoscope treatment tool according to the present invention is an endoscope treatment tool that is inserted into a channel of an endoscope, and includes a wire that can be energized, and has a coil shape on a proximal end side of the wire. A coil sheath wound around is formed, and the distal end side of the strand is a treatment section for treating a target site.

  According to the present invention, by moving the coil sheath back and forth in the channel of the endoscope, the treatment portion can be advanced and retracted in the channel, and can be projected and retracted from the distal end opening of the channel.

  An endoscopic treatment tool according to the present invention is an endoscopic treatment tool that is inserted into a channel of an endoscope, and includes a plurality of strands that can be energized, and a base of the plurality of strands. A coil sheath wound in a coil shape is formed on the end side, and at least one distal end side of the plurality of strands is a treatment portion for treating a target site.

  In the present invention, since the coil sheath is a multi-strip coil, when the coil sheath is rotated, the torque transmission to the treatment portion can be improved, and the rotation followability of the treatment portion with respect to the channel can be improved.

The endoscope treatment tool according to the present invention is the endoscope treatment tool, wherein the treatment portion extends in a central axis direction of the coil sheath.
According to the present invention, the treatment portion can be made into a needle shape, and incision or the like of the target site can be easily performed.

  Further, the endoscope treatment tool according to the present invention is the endoscope treatment tool, wherein a distal end of the treatment portion is bent and bent in a direction intersecting the central axis. And

  According to the present invention, the target site can be hooked at the distal end of the treatment portion. At this time, if the bending direction of the distal end of the treatment portion is different from the desired direction, the rotational torque can be more suitably transmitted to the treatment portion by rotating the coil sheath around the central axis, and the desired direction Can be reliably directed in a short time.

The endoscope treatment tool according to the present invention is the endoscope treatment tool, wherein an insulator is connected to a distal end of the treatment portion.
According to the present invention, even when the treatment portion is energized, it is possible to regulate the contact of the distal end of the treatment portion to the target site by the insulator.

  An endoscope treatment tool according to the present invention is the endoscope treatment tool, wherein the coil sheath is housed so as to be movable forward and backward in a central axis direction, and the flexible tube includes the flexible tube. And an operating portion for moving the coil sheath back and forth. According to the present invention, the treatment section can be moved back and forth with respect to the channel while the treatment section is housed in the flexible tube, and the channel wall surface and the treatment section can be protected from each other.

  Further, the endoscope treatment tool according to the present invention is the endoscope treatment tool, wherein the distal end of the flexible tube from which the treatment portion protrudes and sinks is formed from the inner peripheral surface of the flexible tube. A locking portion is provided that protrudes to a position radially inward of the coil sheath and radially outward of the treatment portion.

  According to the present invention, when the coil sheath is advanced with respect to the flexible tube by the operation portion, the coil sheath can be brought into contact with the locking portion so that the treatment portion does not protrude further from the flexible tube. Therefore, it is possible to suitably restrict the coil sheath from protruding from the flexible tube with a length longer than necessary.

  An endoscope treatment tool that is inserted into a channel of an endoscope, comprising a power supply unit that supplies high-frequency power to the treatment unit via the coil sheath. And a flexible tube that accommodates the plurality of strands so as to be able to advance and retreat in the direction of the central axis, and a coil sheath wound in a coil shape is formed on the proximal end side of the plurality of strands, A distal end side of at least two of the strands is formed with a plurality of arm portions that are gradually spaced apart from the vicinity of the central axis and are expanded larger than the outer diameter of the flexible tube. And

  According to the present invention, the pair of arm portions can be expanded by advancing the coil sheath in a direction in which the pair of arm portions protrude from the flexible tube. In addition, by retracting the coil sheath in a direction to immerse the pair of arms into the flexible tube, each expanded wire can be reduced in diameter while abutting against the end surface of the flexible tube, The target part can be gripped between the pair of arms.

The endoscopic treatment tool according to the present invention is the endoscopic treatment, and further includes a power supply unit that supplies high-frequency power to the treatment unit via the coil sheath.
According to the present invention, the target site can be incised by supplying high-frequency power in a state where the treatment portion is in contact with the target site as an electrode.

In addition, the endoscope treatment tool according to the present invention is the endoscope treatment, wherein the treatment portion is formed by releasing one end of the coil sheath.
According to the present invention, the treatment portion and the coil sheath can be formed in an integrated state from the beginning of manufacture.

  According to the present invention, it is possible to easily assemble in a short time by reducing the parts and processes involved in manufacturing.

A first embodiment according to the present invention will be described with reference to FIGS. 1 and 2.
A high-frequency needle scalpel (endoscope treatment tool) 1 according to the present embodiment is an endoscope treatment tool that is inserted into a channel of an endoscope (not shown), and is not shown in FIG. A treatment section 2 for treating a target site, a coil sheath 3 formed by winding a conductive wire 3a extending in the direction of the central axis C in a coil shape, and the coil sheath 3 can be advanced and retracted in the direction of the central axis C. A resin tube (flexible tube) 5 housed in the housing, and a coil sheath 3 and a proximal end of the resin tube 5 are connected to each other, and an operation unit 6 for moving the coil sheath 3 forward and backward with respect to the resin tube 5 is provided.

  The treatment portion 2 is formed by extending a predetermined length in the direction of the central axis C of the coil sheath 3 by unraveling the distal end side of the wire 3 a of the coil sheath 3. That is, the treatment part 2 and the coil sheath 3 are manufactured in advance integrally.

  The wire 3a of the coil sheath 3 is made of stainless steel and can be energized. In addition, in order to reduce the magnitude | size of the impedance of the coil sheath 3, after the strand 3a is wound, gold plating, silver plating, or copper plating may be given to the surface. Further, instead of stainless steel, a wire made of a material such as tungsten or molybdenum may be used. Furthermore, gold plating, silver plating, or copper plating may be applied to this surface.

  The operation unit 6 includes an operation unit main body 7 to which the base end of the resin tube 5 is connected, and a slider 8 to which the base end of the coil sheath 3 is connected and is disposed so as to be movable forward and backward with respect to the operation unit main body 7. Yes. The slider 8 is provided with an electrode terminal 12 that is electrically connected to the coil sheath 3 and connected via a connection cord 11 to a power supply unit 10 that supplies high-frequency power.

Next, the operation of the high-frequency needle scalpel 1 according to this embodiment will be described.
First, the slider 8 is moved to the proximal end side with respect to the operation portion main body 7 so that the treatment portion 2 is immersed in the resin tube 5 as shown in FIG. In this state, the tube is inserted into a channel of an endoscope (not shown) inserted into the body cavity, and the tip of the resin tube 5 is projected near the target site (not shown).

  Then, the connection cord 11 and the electrode terminal 12 are connected, the slider 8 is moved forward with respect to the operation portion main body 7, the coil sheath 3 is moved with respect to the resin tube 5, and as shown in FIG. 2 is protruded from the tip of the resin tube 5. In this state, high frequency power is supplied from the power supply unit 10, and the target site is incised while operating the endoscope. When the treatment is completed, the slider 8 is moved to the proximal end side with respect to the operation portion main body 7, and the treatment portion 2 is immersed in the resin tube 5.

  During the treatment or between energizations, the operation unit body 7 and a water supply device (not shown) are connected, and water is supplied from the water supply device to the operation unit body 7 for cleaning. At this time, the resin tube 5 and the coil sheath 3 serve as a water supply pipe, and water is supplied from the tip of the resin tube 5 to the target site.

  According to this high frequency needle scalpel 1, the treatment tube 2 is channeled while the treatment tube 2 is housed in the resin tube 5 by moving the resin tube 5 provided with the coil sheath 3 forward and backward in the channel of the endoscope. The channel wall surface and the treatment portion 2 can be protected from each other. Further, the treatment section 2 can be protruded and retracted from the resin tube 5 by moving the coil sheath 3 forward and backward with respect to the resin tube 5.

  In particular, since the distal end side of the strand 3a of the coil sheath 3 is formed linearly along the central axis C, it is shorter than the case where the treatment portion 2 is provided on the operation wire that moves forward and backward in the coil sheath as in the prior art. Can be manufactured in time. Therefore, it is possible to reduce the number of parts and processes involved in manufacturing and to assemble easily and in a short time.

Further, by extending the distal end side of the coil sheath 3 linearly in the direction of the central axis C, the needle-like treatment portion 2 can be easily formed, and incision or the like of the target site can be easily performed.
Furthermore, since a conventional operation wire is not required for water supply, the operation wire can be smoothly supplied to the tip of the resin tube 5 without causing resistance during water supply.

  As shown in FIG. 3, the tip of the resin tube 13 is bent and protrudes from the inner peripheral surface of the coil sheath 3 to a position that is radially inner than the coil sheath 3 and radially outer than the treatment portion 2. It is good also as the high frequency needle knife 16 with which the latching | locking part 15 is provided. In this case, even if the coil sheath 3 is moved forward with respect to the resin tube 13, the treatment portion 2 can be regulated so as not to protrude further from the resin tube 13 by the coil sheath 3 coming into contact with the locking portion 15. .

  Further, as shown in FIG. 4, for example, a stainless steel locking portion 17 formed in a ring shape may be a high-frequency needle-shaped knife 19 provided on the inner peripheral surface of the tip of the resin tube 18. Also in this case, when the coil sheath 3 is moved forward with respect to the resin tube 18, the coil sheath 3 can be brought into contact with the locking portion 17 to restrict the protrusion of the treatment portion 2 from the resin tube 18.

Next, a second embodiment will be described with reference to FIG.
In addition, the same code | symbol is attached | subjected to the component similar to 1st Embodiment mentioned above, and description is abbreviate | omitted.
The difference between the second embodiment and the first embodiment is that the treatment section 21 of the hook knife (endoscopic treatment tool) 20 according to this embodiment is different from the treatment section 2 according to the first embodiment. The tip side is formed by being bent.

A locking portion 23 is formed at the tip of the resin tube 22 by being bent radially inward so that the tip opening of the resin tube 22 has a predetermined radius R.
The treatment portion 21 is composed of the strand 3a of the coil sheath 3, and is bent in a direction perpendicular to the direction of the central axis C with respect to the straight portion 25 extending along the central axis C of the coil sheath 3 and the straight portion 25. And a hook portion 26. The length (hook length) L1 of the hook portion 26 is such a length that the tip opening of the resin tube 22 can pass through.

The operation of the hook knife 20 will be described.
First, similarly to the first embodiment, the resin tube 22 in which the hook portion 26 is housed is projected from the distal end of an endoscope (not shown) inserted into the body cavity. Then, the slider (not shown) is moved forward with respect to the operation portion main body (not shown), the coil sheath 3 is moved relative to the resin tube 22, and the treatment portion 21 is protruded from the distal end of the resin tube 22.

  At this time, if the direction of the hook portion 26 protrudes in a state extending in a direction different from the direction of the target tissue (not shown), the slider is rotated around the axis of the operation portion main body. At this time, the coil sheath 3 rotates with respect to the resin tube 22. Then, with the hook portion 26 facing in a desired direction, high frequency power is supplied from a power supply unit (not shown), and the target site is incised while operating the endoscope. When the treatment is completed, the slider 8 is moved to the proximal end side with respect to the operation portion main body 7, and the treatment portion 21 is immersed in the resin tube 22. Note that water may be fed into the coil sheath 3 as in the first embodiment.

  According to the hook knife 20, the target portion can be hooked by the hook portion 26. At this time, if the bending direction of the hook portion 26 is different from the desired direction, the coil sheath 3 can be rotated around the central axis C. Thereby, since the radius of rotation is larger than in the case where the operation wire is rotated as in the prior art, the rotational torque can be more suitably transmitted to the hook portion 26 and can be reliably directed in a desired direction in a short time.

Next, a third embodiment will be described with reference to FIG.
In addition, the same code | symbol is attached | subjected to the component similar to other embodiment mentioned above, and description is abbreviate | omitted.
The difference between the third embodiment and the second embodiment is that the straight portion 32 of the treatment portion 31 of the hook knife 30 according to this embodiment is not on the central axis C of the coil sheath 3 but from the central axis C. The distance L2 is offset and extends.

That is, the length L3 of the hook portion 33 is formed longer than the hook portion 26 of the hook knife 20 according to the second embodiment.
According to the hook knife 30, the same effect as that of the second embodiment can be obtained. Furthermore, by offsetting the straight line portion 32 with respect to the central axis C, the length of the hook portion 33 can be increased, and the hooking with the target tissue can be improved to facilitate the procedure.

Next, a fourth embodiment will be described with reference to FIG.
In addition, the same code | symbol is attached | subjected to the component similar to other embodiment mentioned above, and description is abbreviate | omitted.
The difference between the fourth embodiment and the second embodiment is that the coil sheath 36 of the hook knife 35 according to the present embodiment is wound as, for example, two strands 36a and 36b. It is the point that it was formed.

The treatment portion 37 is formed by, for example, unraveling the strand 36a of the strands 36a and 36b.
According to the hook knife 35, it is possible to improve the transmission performance of the rotational torque as compared with the case where there is only one strand. Therefore, the direction of the hook portion 38 relative to the straight portion 39 can be changed more quickly at a more accurate position.

  The coil sheath 3 is not limited to two strands, but may be three or more. Even in this case, the tip of any one of the strands becomes the treatment portion.

Next, a fifth embodiment will be described with reference to FIGS.
In addition, the same code | symbol is attached | subjected to the component similar to other embodiment mentioned above, and description is abbreviate | omitted.
The difference between the fifth embodiment and the first embodiment is that the two-legged forceps (endoscopic treatment tool) 40 according to this embodiment can be energized as shown in FIG. The coil sheath 41 in which the coils 41a and 41b are wound in a coil shape, the resin tube 42 that accommodates the coil sheath 41 so as to be capable of moving forward and backward in the direction of the central axis C, and the distal ends of the two strands 41a and 41b are The treatment portion 45 is a pair of arm portions 43A and 43B which are gradually separated and expanded larger than the outer diameter of the resin tube 42.

  The pair of arm portions 43A and 43B are provided so as to face each other across the central axis C. And the surface side which mutually opposes is previously curved and formed in convex shape, and the nail | claw part 46 bent by the central axis C direction is distribute | arranged to the front-end | tip. The pair of arm portions 43 </ b> A and 43 </ b> B can be elastically deformed by coming into contact with the tip of the resin tube 42. An insulating coating (not shown) is provided on the surfaces of the pair of arm portions 43A and 43B and the coil sheath 41 excluding the claw portion 46.

Next, the operation of the bipod forceps 40 according to this embodiment will be described.
First, as in the first embodiment, the resin tube 42 in which the pair of arm portions 43A and 43B are housed is protruded from the distal end of an endoscope (not shown) inserted into the body cavity. Then, the slider (not shown) is moved forward with respect to the operation portion main body (not shown), the coil sheath 41 is moved relative to the resin tube 42, and the treatment portion 45 is protruded from the distal end of the resin tube 42.

At this time, since the pair of arm portions 43A and 43B are urged and stored in the closing direction by the resin tube 42, the pair of arm portions 43A and 43B are sequentially moved from the distal end side by protruding from the resin tube 42. It will be expanded.
However, when the opening / closing direction of the pair of arm portions 43A and 43B protrudes in a direction different from the direction in which the target tissue (not shown) is to be gripped, the slider is rotated around the axis of the operation unit main body. At this time, the coil sheath 41 rotates with respect to the resin tube 42.

  Then, after the pair of arm portions 43A and 43B are in a desired direction, the slider is now retracted relative to the operation portion main body. At this time, as shown in FIG. 9, the pair of arm portions 43 </ b> A and 43 </ b> B are drawn into the resin tube 42. At this time, the pair of arm portions 43A and 43B approach each other and grasp a target tissue (not shown). Thus, while supplying high frequency power from a power source (not shown) and operating the endoscope, as shown in FIG. 10, the pair of arms 43A and 43B are immersed in the resin tube 42 and the target part is gripped. Shochu in. Note that water may be fed into the coil sheath 41 as in the first embodiment.

  According to the two-legged forceps 40, the pair of arm portions 43A and 43B can be expanded by advancing the coil sheath 41 in a direction in which the pair of arm portions 43A and 43B protrude from the resin tube 42. Further, by retracting the coil sheath 41 in a direction in which the pair of arm portions 43A and 43B are immersed in the resin tube 42, the pair of expanded arm portions 43A and 43B are contracted while being brought into contact with the end surface of the resin tube 42. The target portion can be gripped between the pair of arm portions 43A and 43B.

  At this time, since the two strands 41a and 41b are wound in a coil shape to form the coil sheath 41, the transmission performance of the rotational torque to the treatment portion 45 can be improved as in the fourth embodiment. And operability can be improved. The coil sheath 41 is not limited to having two strands, but may be three or more. In this case, a pair of arm portions 43A and 43B are formed by any two strands.

Next, a sixth embodiment will be described with reference to FIGS.
In addition, the same code | symbol is attached | subjected to the component similar to other embodiment mentioned above, and description is abbreviate | omitted.
The difference between the sixth embodiment and the fifth embodiment is that the coil sheath 51 of the tripod forceps (endoscopic treatment tool) 50 according to this embodiment can be energized as shown in FIG. The three strands 51a, 51b, 51c are wound in a coil shape, and the distal ends of the three strands 51a, 51b, 51c are gradually separated from the vicinity of the central axis C as the treatment portion 52, and the resin tube The plurality of arm portions 53A, 53B, and 53C are larger than the outer diameter of 42.

  Each arm part 53A, 53B, 53C is made into the same shape as a pair of arm part 43A, 43B which concerns on 5th Embodiment, and the same nail | claw part 46 is distribute | arranged to the front-end | tip. As shown in FIG. 11B, the three arm portions 53A, 53B, and 53C are arranged at substantially equal intervals in the circumferential direction.

  As shown in FIGS. 12 and 13, the tripod forceps 50 retreats the coil sheath 51 with respect to the resin tube 42 by the same action as the bipedal forceps 40 according to the fifth embodiment. The arm portions 53A, 53B, and 53C can be immersed therein. And the effect similar to the bipod forceps 40 which concerns on 5th Embodiment can be show | played. The coil sheath 51 is not limited to having three strands, and may be four or more. In this case, the arm portions 53A, 53B, and 53C are formed by any three strands.

The technical scope of the present invention is not limited to the above embodiment, and various modifications can be made without departing from the spirit of the present invention.
For example, with respect to the high-frequency needle scalpel 16 which is a modified example of the first embodiment, as shown in FIG. A needle-shaped knife 56 may be used. Also in this case, the same operations and effects as those of the first embodiment can be achieved. In particular, since the insulating chip 55 is disposed at the distal end of the treatment portion 2, it is possible to suitably suppress the incision in the distal direction.

  In the above embodiment, the hook knives 20, 30, 35, the bipod forceps 40, and the tripod forceps 50 are all connected to the power supply unit 10 so that a high frequency current flows through the coil sheath. It does n’t matter if you do n’t.

It is the (a) whole schematic diagram and (b) front view showing the high frequency needle scalpel concerning a 1st embodiment of the present invention. 1 is an overall schematic diagram showing a high-frequency needle scalpel according to a first embodiment of the present invention. It is a principal part schematic diagram which shows the modification of the high frequency needle knife which concerns on the 1st Embodiment of this invention. It is a principal part schematic diagram which shows the modification of the high frequency needle knife which concerns on the 1st Embodiment of this invention. It is a principal part schematic diagram which shows the hook knife which concerns on the 2nd Embodiment of this invention. It is a principal part schematic diagram which shows the hook knife which concerns on the 3rd Embodiment of this invention. It is a principal part schematic diagram which shows the hook knife which concerns on the 4th Embodiment of this invention. It is a principal part schematic diagram which shows the bipedal forceps concerning the 5th Embodiment of this invention. It is explanatory drawing which shows the use condition of the bipod forceps concerning the 5th Embodiment of this invention. It is explanatory drawing which shows the use condition of the bipod forceps concerning the 5th Embodiment of this invention. It is the (a) principal part schematic diagram and (b) front view which show the tripod forceps concerning the 6th Embodiment of this invention. It is explanatory drawing which shows the use condition of the tripod forceps concerning the 6th Embodiment of this invention. It is explanatory drawing which shows the use condition of the tripod forceps concerning the 6th Embodiment of this invention. It is a principal part schematic diagram which shows the modification of the high frequency needle knife which concerns on the 1st Embodiment of this invention.

Explanation of symbols

1,16,19,56 High frequency needle scalpel (endoscopic instrument)
2, 21, 37, 45, 52 Treatment section 3, 36, 41, 51 Coil sheath 3a, 36a, 36b, 41a, 41b, 51a, 51b, 51c Wire 5, 13, 18, 22, 42 Resin tube (flexible tube)
10 Power supply unit 20, 30, 35 Hook knife (endoscopic treatment tool)
40 Biped forceps (endoscopic instrument)
50 Tripod forceps (endoscopic instrument)
55 Insulation chip (insulator)

Claims (10)

An endoscopic treatment tool inserted into an endoscope channel,
It has a wire that can be energized,
A coil sheath wound in a coil shape is formed on the base end side of the strand,
A treatment instrument for an endoscope, wherein a distal end side of the element wire is a treatment portion for treating a target site. An endoscopic treatment tool inserted into an endoscope channel,
It has multiple strands that can be energized,
A coil sheath wound in a coil shape is formed on the base end side of the plurality of strands,
An endoscope treatment tool, wherein a distal end side of at least one of the plurality of strands is a treatment portion for treating a target site.   The endoscopic treatment instrument according to claim 1, wherein the treatment portion extends in a central axis direction of the coil sheath.   The treatment instrument for an endoscope according to claim 3, wherein a distal end of the treatment portion is bent and bent in a direction intersecting the central axis.   The endoscope treatment tool according to claim 3, wherein an insulator is connected to a distal end of the treatment portion. A flexible tube that houses the coil sheath so as to freely advance and retract in the direction of the central axis;
The endoscopic treatment tool according to any one of claims 1 to 5, further comprising an operation unit configured to move the coil sheath forward and backward with respect to the flexible tube.   A lock projecting from the inner peripheral surface of the flexible tube to a position radially inward of the coil sheath and radially outward of the treatment portion at the distal end of the flexible tube from which the treatment portion protrudes and sinks The endoscopic treatment tool according to claim 6, wherein a portion is provided. An endoscopic treatment tool inserted into an endoscope channel,
Multiple wires that can be energized,
A flexible tube that accommodates the plurality of strands so as to freely advance and retract in the central axis direction;
A coil sheath wound in a coil shape is formed on the base end side of the plurality of strands,
A distal end side of at least two of the strands is formed with a plurality of arm portions that are gradually spaced apart from the vicinity of the central axis and are expanded larger than the outer diameter of the flexible tube. Endoscopic treatment tool.   The endoscope treatment tool according to any one of claims 1 to 8, further comprising a power supply unit that supplies high-frequency power to the treatment unit via the coil sheath. The endoscopic treatment instrument according to claim 1, wherein the treatment portion is formed by releasing one end of the coil sheath.

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