JP4589511B2 - Endoscopic high frequency snare - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
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 excising a polyp or the like.
[0002]
[Prior art]
As shown in FIG. 4, a high-frequency snare for an endoscope is generally a snare formed by a conductive elastic wire 11 by inserting an operation wire 2 through a flexible sheath 1 so as to be able to advance and retreat in the axial direction. The loop 10 is connected to the tip of the operation wire 2 and is configured so that a high-frequency current can be applied to the elastic wire 11. The snare loop 10 is moved forward and backward in the axial direction so that the snare loop 10 can be The snare loop 10 enters and exits, and the snare loop 10 swells by its own elasticity outside the flexible sheath 1, and is narrowed by being drawn into the flexible sheath 1.
[0003]
When the polyp is surrounded by the snare loop 10 at the time of use, the operation wire 2 is pulled toward the hand side, thereby binding the polyp 100 with the snare loop 10 to form the snare loop 10 as shown in FIG. The polyp 100 can be cauterized and cut by supplying a high-frequency current to the elastic wire 11 to be wound.
[0004]
[Problems to be solved by the invention]
The endoscopic high-frequency snare needs to be retracted by retracting the snare loop 10 into the flexible sheath 1 when the endoscope is inserted into and removed from the treatment instrument insertion channel.
[0005]
Therefore, the snare loop 10 cannot be formed as a simple loop as a whole, and as shown in FIG. 4, the snare loop 10 is flexible by bending the elastic wire 11 forward as shown in FIG. 4. A small protrusion 14 that can pass through the sheath 1 is formed.
[0006]
By adopting such a configuration, as shown in FIG. 6, the snare loop 10 can be drawn into the flexible sheath 1 so as to prevent the elastic wire 11 from being plastically deformed. The snare loop 10 extruded from can be expanded to its original size again.
[0007]
However, since such a protrusion 14 protrudes forward from the tip of the snare loop 10, as shown in FIG. 7, the protrusion 14 touches the mucosal surface when the polyp 100 is bound with the snare loop 10. In some cases, the surrounding mucous membrane surface is cauterized by a high-frequency current and burned.
[0008]
Accordingly, the present invention provides a high-frequency endoscope high-frequency snare that is free from the risk of cauterizing the mucosal surface by a protrusion at the tip of the snare loop when a polyp is excised by energizing a high-frequency current. Objective.
[0009]
[Means for Solving the Problems]
In order to achieve the above object, the endoscope high-frequency snare of the present invention is formed in a loop shape by a conductive elastic wire, and a protrusion formed by bending the elastic wire forward is formed at the tip portion. The snare loop is connected to the tip of an operation wire that is inserted in the flexible sheath so as to be movable back and forth in the axial direction, and a high-frequency current can be passed through the elastic wire, and the operation wire is advanced and retracted in the axial direction. By operating, the snare loop enters and exits into the distal end of the flexible sheath, and the snare loop is swollen by its own elasticity outside the flexible sheath and is squeezed by being pulled into the flexible sheath. In the high-frequency snare for endoscope, the surface of the protrusion formed at the tip of the snare loop is formed of an electrical insulating material.
[0010]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described with reference to the drawings.
FIG. 1 shows an endoscopic high-frequency snare according to an embodiment of the present invention. Reference numeral 1 denotes a flexible sheath made of, for example, an electrically insulating tetrafluoroethylene resin tube, which is not shown. It is inserted into and removed from the treatment instrument insertion channel of the endoscope.
[0011]
A flexible conductive metal operation wire 2 is inserted through the entire length of the flexible sheath 1 so as to be movable back and forth in the axial direction, and can be freely advanced and retracted from the proximal end side by an operation portion not shown. Operated.
[0012]
A snare loop 10 formed by bending a single conductive elastic wire 11 into a loop shape is connected to the distal end portion of the operation wire 2 via a connection pipe 3, and the snare loop is connected via the operation wire 2. 10 can be energized with a high-frequency current.
[0013]
As the elastic wire 11 forming the snare loop 10, for example, a single wire or a stranded wire of a stainless steel wire is used. In addition, the operation wire 2 may be formed by extending the elastic wire 11.
[0014]
In the state where no external force is applied, the snare loop 10 forms a loop with a spread of several centimeters as shown in FIG. 1 by the elasticity of the elastic wire 11, and the operation wire 2 is pulled toward the hand side. Then, the snare loop 10 is drawn into the flexible sheath 1 and is elastically deformed to be narrowed.
[0015]
At the tip portion of the snare loop 10, a protruding portion 14 having a shape in which the elastic wire 11 is bent in parallel with a narrow width toward the front and bent back into a U shape at the most distal portion is formed to protrude forward. Thus, the snare loop 10 can be drawn into the flexible sheath 1 so that the elastic wire 11 is not plastically deformed, and the snare loop 10 pushed out of the flexible sheath 1 again expands to its original size. be able to.
[0016]
The protrusion 14 is provided with an electrically insulating coating such as a fluorine resin, an epoxy resin, a polyimide resin, or the like. Instead of coating, a dissolved resin or the like may be applied, or the surface of the protrusion 14 may be electrically insulated by other means such as covering a thin tube.
[0017]
FIG. 2 shows that a polyp 100 is cut by operating an operation unit (not shown) to pull the operation wire 2 toward the hand side, binding the polyp with the snare loop 10 and energizing the elastic wire 11 with a high-frequency current. It shows the state of being applied.
[0018]
By applying a high-frequency current to the elastic wire 11 of the snare loop 10, the polyp 100 is cut without bleeding while the human tissue (the stem of the polyp 100) in contact with the elastic wire 11 is heated and solidified by Joule heat. .
[0019]
At this time, since the electrically insulating coating is applied to the protrusion 14, no high frequency current flows between the protrusion 14 and the mucosal surface even if the protrusion 14 touches the mucosal surface (or flow). However, the mucosal surface in contact with the protrusion 14 is not cauterized, and only the cut portion of the polyp 100 is cauterized.
[0020]
The present invention is not limited to the above-described embodiment. For example, as shown in FIG. 3, a high-frequency wave in which a binding pipe 15 that binds two elastic wires 11 is protruded and attached to the tip of the snare loop 10. In the case of a snare, the outer surface of the binding pipe 15 may be formed of an electrical insulating material, and the binding pipe 15 itself may be formed of an electrical insulating material.
[0021]
【The invention's effect】
According to the present invention, since the surface of the protrusion formed at the tip of the snare loop is formed of the electrical insulating material, a high-frequency current is generated between the protrusion and the mucosal surface even if the protrusion touches the mucosal surface. Since it does not flow (or very little even if it flows), polyp or the like can be cut more safely without cauterizing the mucosal surface by the protrusion at the tip of the snare loop.
[Brief description of the drawings]
FIG. 1 is a plan sectional view of a distal end portion of a high-frequency endoscope snare according to a first embodiment of the present invention.
FIG. 2 is a perspective view showing a state in which a polyp is being cut by the endoscope high-frequency snare according to the first embodiment of the present invention.
FIG. 3 is a plan view of a front half of a snare loop according to a second embodiment of the present invention.
FIG. 4 is a plan sectional view of a distal end portion of a conventional endoscope high-frequency snare.
FIG. 5 is a perspective view showing a state in which a polyp is being cut by a conventional endoscopic high-frequency snare.
FIG. 6 is a plan sectional view showing a state in which a snare loop (elastic wire) of a conventional endoscope high-frequency snare is housed in a flexible sheath.
FIG. 7 is a perspective view showing a state in which a polyp is being cut by a conventional endoscopic high-frequency snare.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Flexible sheath 2 Operation wire 10 Snare loop 11 Elastic wire 14 Protrusion part 15 Bundling pipe 100 Polyp

Claims (1)

A snare loop formed by a conductive elastic wire in a loop shape and having a protruding portion formed by bending the elastic wire forward in a U shape at the distal end portion is formed in the flexible sheath in the axial direction. The operation wire is connected to the tip of an operation wire that is inserted and retracted freely, and a high-frequency current can be applied to the elastic wire, and the snare loop is made flexible by operating the operation wire in the axial direction. In the high-frequency endoscope snare that enters and exits the distal end of the sheath, the snare loop swells by its own elasticity outside the flexible sheath, and narrows by being drawn into the flexible sheath.
The surface of the protruding portion is electrically insulated by applying an electrically insulating coating on the surface of the U-shaped protruding portion formed at the tip of the snare loop with the elastic wire itself forming the snare loop. A featured high-frequency snare for endoscopes.

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