JP4589731B2 - Endoscopic high-frequency treatment instrument - Google Patents

Description

  The present invention relates to an endoscope high-frequency treatment instrument provided with a needle-like high-frequency electrode that projects forward and backward from the distal end of a sheath inserted into and removed from a treatment instrument insertion channel of an endoscope.

  An endoscopic high-frequency treatment instrument for incising / coagulating mucosal tissue in the body is a mucosal tissue in which the mucosal surface to be treated is washed before incision and burned during the incision to adhere to the electrode and its surroundings. It is desirable to be able to wash away the shochu pieces.

Therefore, the high-frequency treatment instrument for endoscope protrudes forward from the distal end of the sheath into the electrically insulating sheath that is inserted into and removed from the treatment instrument insertion channel of the endoscope by an operation from the proximal side of the sheath. There is one in which a high-frequency electrode is provided and a space surrounding the periphery of the high-frequency electrode (and the operation wire connected to the high-frequency electrode) is used as a water supply path for allowing water to be ejected from the tip of the sheath to pass through ( For example, Patent Document 1).
JP-A-6-292585

  However, if the space surrounding the periphery of the high-frequency electrode is used as a water supply channel, the amount of water supply and the state of water flow are greatly different between when the high-frequency electrode protrudes from the distal end of the sheath and when it retracts into the sheath. May be very difficult to use.

  Therefore, it is conceivable to provide a wire insertion hole through which the operation wire connected to the high-frequency electrode is inserted in the sheath and the water supply path in parallel independently of each other. However, when the high-frequency electrode is arranged at the axial position of the sheath, it is considered that However, if the high-frequency electrode is not located at the sheath axial position, the position of the needle-shaped high-frequency electrode may not be grasped during the incision operation, which may be very difficult to use. .

  Therefore, the present invention is for an easy-to-use endoscope in which the amount of water flow and the state of water flow ejected from a water supply channel are not affected by the protruding and retracting state of the high-frequency electrode, and the high-frequency electrode can protrude and retract at the axial position of the sheath. An object is to provide a high-frequency treatment instrument.

  In order to achieve the above object, a high-frequency treatment instrument for an endoscope according to the present invention includes a sheath that is inserted into and removed from a treatment instrument insertion channel of an endoscope by an operation from the proximal side of the sheath. An endoscopic high-frequency treatment instrument provided with a needle-like high-frequency electrode protruding forward from the distal end of the tube and a water supply path for allowing water to be ejected from the distal end of the sheath. A wire insertion hole through which the connected operation wire is inserted so as to be able to advance and retract in the axial direction and a water supply path are formed in parallel to each other at a position eccentric from the axial position of the sheath, and the high-frequency electrode is connected to the sheath axial line. It is eccentrically connected to the operation wire so as to protrude from the distal end of the sheath at the position.

  Note that the high-frequency electrode and the operation wire may be connected by directly fixing the side surfaces of each other without using another connecting member, and the high-frequency electrode is restricted from swinging at the tip of the wire insertion hole. An electrode fluctuation regulating member for this purpose is preferably provided at the distal end portion of the sheath.

  The electrode fluctuation restricting member is formed with an electrode guide hole through which the high frequency electrode passes but the operation wire does not pass, and the electrode guide restricting member is in a state where the electrode guide hole is disposed at the axial position of the sheath. It may be fixed to the most distal portion of the sheath.

  According to the present invention, the wire insertion hole through which the operation wire connected to the high-frequency electrode is inserted into the sheath so as to be able to advance and retreat in the axial direction and the water supply path are respectively positioned at positions eccentric from the axial position of the sheath. By forming them in parallel, the amount of water flow and the state of water flow ejected from the water supply channel are not affected by the protruding and retracting state of the high-frequency electrode, and the high-frequency electrode protrudes and retracts from the sheath tip at the sheath axial position. Since the high-frequency electrode can be projected and subtracted at the axial position of the sheath by being eccentrically connected to the operation wire, it is very easy to use, and the high-frequency electrode is provided by providing an electrode wobbling restricting member at the distal end portion of the sheath. Can be used more safely.

  A needle-like high-frequency electrode that protrudes forward and backward from the distal end of the sheath by an operation from the proximal side of the sheath into an electrically insulating sheath that is inserted into and removed from the treatment instrument insertion channel of the endoscope, and ejected from the distal end of the sheath In an endoscope high-frequency treatment instrument provided with a water supply path for allowing water to pass therethrough, a wire insertion hole through which an operation wire connected to the high-frequency electrode is inserted into the sheath so as to be movable forward and backward in the axial direction. The water channel is formed in parallel with each other at a position eccentric from the axial position of the sheath, and the high frequency electrode is eccentrically connected to the operation wire so as to protrude from the sheath tip at the axial position of the sheath. To do.

Embodiments of the present invention will be described with reference to the drawings.
2 and 3 are a plan view and a side sectional view showing the overall configuration of the endoscope high-frequency treatment instrument according to the first embodiment of the present invention, for example, an electrical insulating property such as tetrafluoroethylene resin. A sheath 1 made of a flexible tube made of synthetic resin is formed with a diameter of about 2 mm and a length of about 1 to 2 m so that it can be inserted into and removed from a treatment instrument insertion channel of an endoscope (not shown). ing.

  As shown in a cross section in FIG. 4, the sheath 1 is a so-called multi-lumen tube in which two through holes of the wire insertion hole 2 and the water supply path 3 are formed in parallel in the axial direction, and the wire insertion hole 2 and the water supply path Each of the three axial positions is eccentric with respect to the position of the axial line 1x of the sheath 1. However, the axis 1x of the sheath 1 is at a position included in the wire insertion hole 2.

  Returning to FIGS. 2 and 3, a needle-like high-frequency electrode 4 is projected and retracted at the distal end of the sheath 1, and an operation unit 10 for projecting and retracting the high-frequency electrode 4 is provided on the sheath 1. It is connected to the base end side (that is, the hand side).

  In the wire insertion hole 2 of the sheath 1, a conductive operation wire 5 made of, for example, a stainless steel stranded wire is inserted and disposed over the entire length so as to be movable back and forth in the axial direction, and a high-frequency electrode 4 is connected to the tip thereof. .

  The proximal end of the operation wire 5 is connected to a slide operation member 12 that is slidably operated with respect to the operation unit main body 11 of the operation unit 10, and the operation wire 5 is operated via the operation wire 5 by operating the slide operation member 12. Thus, the high frequency electrode 4 can be protruded from the tip of the sheath 1. Further, by connecting a high-frequency power cord (not shown) to the connection terminal 13 disposed on the slide operation member 12, a high-frequency current can be supplied to the high-frequency electrode 4 through the operation wire 5.

  The proximal end side of the water supply path 3 of the sheath 1 is connected to the water injection cap 14 disposed in the operation unit 10 through the connection tube 15, and a water injection tool or the like (not shown) is connected to the water injection cap 14. Thus, water or the like can be ejected forward from the water ejection port 3a at the tip of the water supply channel 3 located on the most distal surface of the sheath 1.

  1 shows the vicinity of the distal end of the sheath 1, FIG. 5 is a VV sectional view thereof, and FIG. 6 is a VI-VI sectional view thereof. The high-frequency electrode 4 is formed of a conductive straight metal rod such as a stainless steel bar or the like, and the high-frequency electrode 4 of this embodiment is not sharp but has a sharp tip. It may be a pipe or the like.

  As shown in FIG. 7, such a high-frequency electrode 4 is configured such that the side surfaces of the operation wire 5 are not connected to each other without using another connecting member (that is, the side surface of the most distal portion of the operation wire 5 and the high-frequency electrode). The side surface 4 of the rear side of 4 is directly fixed and connected in a parallel direction by, for example, silver brazing 7 or the like. Therefore, as shown in FIG. 5, the connecting portion can be efficiently accommodated in the wire insertion hole 2 of the sheath 1.

  If such a high-frequency electrode 4 is simply projected and retracted from the distal end of the sheath 1 by the forward / backward movement of the operation wire 5, the position of the high-frequency electrode 4 may fluctuate and become extremely difficult to use. Therefore, an electrode fluctuation regulating member 6 for regulating the fluctuation of the high frequency electrode 4 is fixed in the most distal portion of the wire insertion hole 2.

  The electrode fluctuation restricting member 6 is formed in a columnar shape having a size that can be fitted into the wire insertion hole 2 as shown in FIG. The electrode guide hole 6a having a diameter through which the high-frequency electrode 4 is allowed to advance and retract and the operation wire 5 cannot pass is formed in the vicinity of the edge in a direction parallel to the axis and is inserted into the electrode guide hole 6a. The high-frequency electrode 4 can be smoothly advanced and retracted only in the axial direction without shaking.

  As shown in FIG. 6, the electrode guide hole 6 a is formed at a position where the sheath 1 and the axis coincide with each other when the electrode fluctuation regulating member 6 is fitted in the most distal portion of the wire insertion hole 2. As a result, the position of the axis 4x of the high-frequency electrode 4 located in the electrode guide hole 6a coincides with the position of the axis 1x of the sheath 1.

  Therefore, when the operation wire 5 is moved back and forth in the operation unit 10, the high-frequency electrode 4 protrudes and retracts without swinging forward from the position of the axis 1x of the distal end of the sheath 1, as shown in FIG. The maximum protruding length of the high-frequency electrode 4 is regulated by the front end of the operation wire 5 coming into contact with the rear end surface of the electrode fluctuation regulating member 6 as shown in FIG. Then, water or the like can be ejected from the water ejection port 3a on the distal end surface of the sheath 1 without being affected by the protruding and retracting state of the high-frequency electrode 4.

  10 to 14 show a high-frequency treatment instrument for an endoscope according to a second embodiment of the present invention. In this embodiment, as shown in FIG. 10, the axis 1x of the sheath 1 is a wire insertion hole 2. It is completely out of the position.

  As shown in FIG. 11, the cross-sectional shape of the sheath 1 is completely independent of the wire insertion hole 2 and the water supply path 3 except for the vicinity of the tip, but the XII-XII cross section in FIG. As shown in FIG. 12, the wire insertion hole 2 and the water supply path 3 are gathered in one long hole portion 9, and the connecting portion between the high frequency electrode 4 and the operation wire 5 is arranged in the long hole portion 9. Has been.

  The electrode fluctuation regulating member 6 is formed in a shape that covers a range of about two-thirds of the long hole portion 9 as shown in FIG. 13 which is a single perspective view. An electrode guide hole 6a is formed through the electrode fluctuation regulating member 6 so that the axial line 1x of the sheath 1 and the axial line position coincide with each other when the long hole 9 is fitted.

  Therefore, when the operation wire 5 is moved back and forth in the operation unit 10, the high frequency electrode 4 does not swing forward from the position of the axis 1x of the distal end of the sheath 1 as shown in FIG. As shown in FIG. 11, the maximum protrusion length of the high-frequency electrode 4 is restricted, and the tip of the operation wire 5 is regulated by contacting the rear end surface of the electrode fluctuation regulating member 6.

  Then, water or the like is not affected by the protruding state of the high-frequency electrode 4 from the water outlet 3a (the portion where the long hole portion 9 is not blocked by the electrode fluctuation regulating member 6) on the distal end surface of the sheath 1. Can be ejected.

It is side surface sectional drawing of the front-end | tip vicinity of the high frequency treatment tool for endoscopes of 1st Example of this invention. It is a top view which shows the whole structure of the high frequency treatment tool for endoscopes of the 1st Example of this invention. It is side surface sectional drawing which shows the whole structure of the high frequency treatment tool for endoscopes of 1st Example of this invention. It is sectional drawing in a cross section perpendicular | vertical to the axis line of the multi-lumen tube which comprises the sheath of the high frequency treatment tool for endoscopes of 1st Example of this invention. It is VV sectional drawing in FIG. 1 of the high frequency treatment tool for endoscopes of 1st Example of this invention. It is VI-VI sectional drawing in FIG. 1 of the high frequency treatment tool for endoscopes of the 1st Example of this invention. It is a perspective view of the connection part of the operation wire and high frequency electrode of the high frequency treatment tool for endoscopes of the 1st Example of this invention. It is a single perspective view of the electrode fluctuation regulating member of the high-frequency endoscope instrument for endoscope according to the first embodiment of the present invention. BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is an external perspective view of the vicinity of a distal end of an endoscope high-frequency treatment tool according to a first embodiment of the present invention. It is sectional drawing in a cross section perpendicular | vertical to the axis line of the multi-lumen tube which comprises the sheath of the high frequency treatment tool for endoscopes of the 2nd Example of this invention. It is side surface sectional drawing of the front-end | tip vicinity of the high frequency treatment tool for endoscopes of 2nd Example of this invention. It is XII-XII sectional drawing in FIG. 11 of the high frequency treatment tool for endoscopes of the 2nd Example of this invention. It is a perspective view of the simple substance of the electrode fluctuation | variation control member of the high frequency treatment tool for endoscopes of the 2nd Example of this invention. It is an external appearance perspective view near the front-end | tip of the high frequency treatment tool for endoscopes of the 2nd Example of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Sheath 1x Axis 2 Wire insertion hole 3 Water supply path 3a Water jet 4 High frequency electrode 4x Axis 5 Operation wire 6 Electrode fluctuation control member 6a Electrode guide hole 7 Silver brazing 9 Long hole 10 Operation part

Claims (4)

A needle-like high-frequency electrode that protrudes forward from the distal end of the sheath by an operation from the proximal side of the sheath in an electrically insulating sheath inserted into and removed from the treatment instrument insertion channel of the endoscope, and the sheath In a high-frequency treatment instrument for an endoscope provided with a water supply passage for allowing water to be ejected from the tip,
In the sheath, a wire insertion hole through which an operation wire connected to the high-frequency electrode is inserted so as to be able to advance and retreat in the axial direction and the water supply path are arranged in parallel with each other at positions eccentric from the axial position of the sheath. As it forms,
A high-frequency treatment instrument for an endoscope, wherein the high-frequency electrode is connected eccentrically with respect to the operation wire so as to protrude from a distal end of the sheath at an axial position of the sheath.   The high-frequency treatment instrument for an endoscope according to claim 1, wherein the high-frequency electrode and the operation wire are directly connected to each other without using any other connecting member.   The high-frequency treatment instrument for an endoscope according to claim 1 or 2, wherein an electrode fluctuation regulating member for regulating fluctuation of the high-frequency electrode at the distal end portion of the wire insertion hole is provided at the distal end portion of the sheath. .   The electrode fluctuation restricting member is formed with an electrode guide hole through which the high-frequency electrode passes but the operation wire does not pass, and the electrode fluctuation is in a state where the electrode guide hole is disposed at the axial position of the sheath. The high-frequency treatment instrument for endoscope according to claim 3, wherein the regulating member is fixed to the most distal end portion of the sheath.

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