JP4611772B2 - Endoscopic treatment tool - Google Patents

Description

  The present invention relates to an endoscope treatment tool.

Although there are those that perform various operations as an endoscope treatment tool, by operating the operation wire inserted and removed in the sheath inserted into and removed from the endoscope treatment tool insertion channel in the axial direction, Many treatment tools are used in which a distal treatment member connected to the distal end of an operation wire protrudes from the distal end portion of the sheath (for example, Patent Document 1).
JP 2002-153484 A

  In order to accurately guide the distal treatment member protruding from the distal end of the sheath to the target affected area, the direction of the distal treatment member protruding from the distal end of the sheath can be arbitrarily changed by remote operation from the hand side. Is desirable.

  However, the conventional endoscopic treatment instrument described in Patent Document 1 does not have such a function, and is an endoscopic treatment instrument that is not a type in which the distal treatment member projects from the distal end of the sheath. Some have a bending function, but in such a case, it is necessary to install an operation wire to bend the distal end of the sheath and insert it into the sheath, which makes the structure and operation complicated and realistic. (For example, JP-A-9-262239, JP-A-11-42232, etc.).

  Therefore, a stopper surface facing forward is formed in the vicinity of the connecting portion between the operation wire and the distal treatment member, and a stopper wall that abuts when the stopper surface moves forward is inclined with respect to the stopper surface, so that the distal end portion of the sheath The distal end treatment member protruding from the distal end portion of the sheath is oriented in the inclination direction of the stopper wall with respect to the stopper surface by pushing the operation wire forward from the proximal end side and pressing the stopper surface against the stopper wall. It can be considered to be configured to change correspondingly.

  However, in the case of adopting such a configuration, it is necessary to use a stiff wire for a certain degree as the operation wire in order to push in the distal treatment member. Since it bends in response to the change, there is a conflicting element that it is difficult to change the direction of the distal treatment member at the distal end portion when the waist of the operation wire is strong.

  Therefore, the present invention provides a distal treatment member that protrudes from the distal end portion of the sheath by pushing the manipulation wire forward from the proximal end side and pressing the stopper surface formed on the manipulation wire side against the stopper wall on the sheath side. The structure is such that the direction changes according to the inclination direction of the stopper wall with respect to the stopper surface, and the distal treatment member can be pushed in reliably and the orientation of the distal treatment member can be changed reliably. It aims at providing the treatment tool for endoscopes.

  In order to achieve the above object, an endoscope treatment tool according to the present invention is configured to advance and retract in the axial direction an operation wire that is inserted through a sheath inserted into and removed from a treatment tool insertion channel of an endoscope. An endoscope treatment tool configured such that a distal treatment member connected to the distal end of an operation wire protrudes and sinks from a distal end portion of a sheath, and is disposed forwardly in the vicinity of a connection portion between the operation wire and the distal treatment member. In addition to forming a facing stopper surface, the stopper wall that contacts when the stopper surface moves forward is inclined with respect to the stopper surface and provided at the distal end portion of the sheath, and the operation wire is pushed forward from the proximal side to the stopper. For endoscopes in which the surface is pressed against the stopper wall so that the direction of the distal treatment member protruding from the distal end portion of the sheath changes according to the inclination direction of the stopper wall with respect to the stopper surface In the fixture, the vicinity of the most advanced part of the operation wire is formed with a wire that is more flexible than the part on the near side, or a twisted wire in which a plurality of wires are twisted around one core wire as the operation wire Only the core wire is extended forward at the most advanced portion, and the distal treatment member is formed by the extension portion of the core wire.

  According to the present invention, the distal treatment member can be reliably pushed and operated by using a wire having a certain level of waist strength as the operation wire, and the vicinity of the most distal portion of such an operation wire is closer to the proximal side. By forming the tip treatment member at the extended portion of the core wire by extending only the core wire forward at the most distal portion of the operation wire using a stranded wire, Since the vicinity of the distal end portion of the operation wire tends to bend following the change in the direction of the distal treatment member, the direction of the distal treatment member can be reliably changed.

  The distal end treatment member connected to the distal end of the operation wire protrudes from the distal end portion of the sheath by moving the operation wire inserted and removed in the sheath inserted into and removed from the treatment instrument insertion channel of the endoscope in the axial direction. An endoscopic treatment tool configured to sag, wherein a stopper surface facing forward is formed in the vicinity of a connection portion between an operation wire and a distal treatment member, and abuts when the stopper surface moves forward Tip treatment that protrudes from the distal end portion of the sheath by tilting the stopper wall with respect to the stopper surface and providing it at the distal end portion of the sheath, pushing the operation wire forward from the proximal end side and pressing the stopper surface against the stopper wall In the endoscopic treatment tool in which the direction of the member changes in accordance with the inclination direction of the stopper wall with respect to the stopper surface, the vicinity of the most distal portion of the operation wire is Formed with a wire that is more flexible than the original part, or by using a stranded wire in which a plurality of wires are twisted around a single core wire as an operation wire, only the core wire is extended forward in the most advanced portion, The distal treatment member is formed by the extension portion of the core wire.

Embodiments of the present invention will be described with reference to the drawings.
FIG. 2 is a plan view showing the overall configuration of the endoscope treatment tool, and FIG. 3 is a side sectional view. The endoscope is inserted into and removed from a treatment tool insertion channel of the endoscope (not shown), such as ethylene tetrafluoride resin. A conductive operation wire in which a round bar-shaped high-frequency electrode 2 (tip treatment member) disposed at the distal end portion of the electrically insulating sheath 1 having flexibility as described above is inserted and disposed in the sheath 1 so as to freely advance and retract. 3 is arranged so as to project from the tip of the sheath 1. The operation wire 3 is formed of a stranded wire rich in flexibility.

  Reference numeral 10 denotes an operation portion provided on the proximal end side of the sheath 1, and a slide operation piece is formed in which a slit 12 is formed in the operation portion main body 11 connected to the proximal end of the sheath 1 and is slidable along the slit 12. The base end of the operation wire 3 is fixed to 13, and the operation wire 3 advances and retreats in the axial direction within the sheath 1 by sliding the slide operation piece 13.

  A high-frequency power cord (not shown) can be connected to the connection terminal 14 attached to the slide operation piece 13, and a high-frequency current can be applied to the high-frequency electrode 2 via the operation wire 3 when necessary. it can.

  4 shows the vicinity of the distal end of the sheath 1, and 4 is a connecting member for firmly connecting the distal end of the operation wire 3 and the proximal end of the high-frequency electrode 2, and the axis of the conductive cylindrical metal material A hole corresponding to the outer diameter of the operation wire 3 and a hole corresponding to the outer diameter of the high-frequency electrode 2 are formed at positions from the rear and the front to the intermediate position.

  Then, the distal end portion of the operation wire 3 and the proximal end portion of the high-frequency electrode 2 are respectively inserted from the rear and the front and fixed by silver brazing or the like, and the operation wire 3 and the high-frequency electrode 2 are connected by the connecting member 4. ing.

  A stopper member 5 made of an electrical insulating material is tightly press-fitted and fixedly attached to the most distal portion of the sheath 1. Reference numeral 5z denotes a protrusion protruding from the outer peripheral surface of the stopper member 5 so as to bite into the inner wall of the sheath 1 in order to prevent the stopper member 5 from coming out of the sheath 1. However, the fixing means for the stopper member 5 with respect to the sheath 1 may be any means such as screwing. At the position where the stopper member 5 is attached to the distal end of the sheath 1, the axis 1x of the sheath 1 and the axis 5x of the stopper member 5 coincide.

  The stopper member 5 is slightly larger than the diameter of the high-frequency electrode 2 as shown in FIG. 5 illustrating the VV cross section in FIG. 4 and FIG. 6 illustrating the state where the stopper member 5 is separated from the sheath 1. A slit 5a having a width smaller than the diameter of the connecting member 4 is formed over the entire length in a direction parallel to the axis 5x, and a long groove 1a connected to the slit 5a of the stopper member 5 is formed at the tip of the sheath 1 at the tip of the sheath 1. It is formed in a direction parallel to the axis 1x so as to open to the side.

  Further, the rear end wall (stopper wall) 5b of the stopper member 5 with which the front end surface (stopper surface) 4a of the connecting member 4 abuts when the operation wire 3 is moved forward is inclined with respect to the axis 1x of the sheath 1. It is formed in the shape of a slope.

  On the other hand, since the stopper surface 4a is formed in a direction perpendicular to the axis 1x of the sheath 1, the stopper wall 5b and the stopper surface 4a are relatively inclined. Note that the stopper surface 4a does not necessarily have to be perpendicular to the axis 1x of the sheath 1, and may face obliquely forward.

  The slit 5a formed in the stopper member 5 has an axis 5x (= sheath) from the end of the rear end position of the stopper wall 5b (that is, the position where the stopper wall 5b is closest to the stopper surface 4a) 5e toward the center. 1 is not deep enough to reach the position of the axis 1x).

  However, as shown in FIG. 4, the depth A of the slit 5 a is formed to be greater than or equal to the sum of the radial dimension r4 of the connecting member 4 and the radial dimension r2 of the high-frequency electrode 2. That is, A ≧ r4 + r2. Therefore, the high frequency electrode 2 does not tilt when passing through the slit 5a, and the high frequency electrode 2 can be projected straight in a direction parallel to the axis 1x of the sheath 1.

  As the operation wire 3, for example, a 1 × 7 stranded stainless steel stranded wire 3 a is used except for the vicinity of the most advanced portion. For example, a stranded wire 3b that is more flexible than a 1 × 7 strand such as a 1 × 37 strand or a 1 × 19 strand is connected and connected by a connecting pipe 3c.

  In the endoscope treatment tool of the embodiment configured as described above, the high-frequency electrode 2 protrudes and retracts from the distal end of the sheath 1 by moving the operation wire 3 back and forth from the operation unit 10 side. When the stopper surface 4a is pressed against the stopper wall 5b by pushing forward from the portion 10 side, the connecting member is brought into contact with the stopper wall 5b in the entire surface as shown in FIG. The direction of 4 changes.

  Accordingly, the vicinity of the tip of the operation wire 3 connected to the rear of the connecting member 4 bends in the internal space 1b of the sheath 1, and the direction of the high-frequency electrode 2 connected to the front of the connecting member 4 is the slit 5a of the stopper member 5. It changes in the diagonally forward direction inside (and within the long groove 1a of the sheath 1). In addition, it is desirable that the diameter dimension of the operation wire 3 is approximately equal to or less than the radial dimension of the sheath 1 so that a space for the operation wire 3 to bend is secured in the internal space 1 b of the sheath 1.

  Here, the inclination direction of the stopper wall 5b and the position of the slit 5a are formed to correspond to each other, and the direction of the high-frequency electrode 2 that changes when the stopper surface 4a strongly contacts the stopper wall 5b, and the stopper wall 5b. Since the direction in which the high-frequency electrode 2 is guided coincides with each other, the direction of the high-frequency electrode 2 changes along the slit 5a.

  And since it is formed with a relatively strong 1 × 7 stranded wire 3a except for the vicinity of the most distal portion of the operation wire 3, the pushing operation force from the hand side is reliably transmitted to the tip side. At the same time, the vicinity of the foremost portion is formed of a flexible stranded wire 3b, so that it can easily bend following the direction change of the high-frequency electrode 2 in the internal space 1b of the sheath 1, so that the high-frequency electrode 2 The direction of the will definitely change.

  Further, since the slit 5a is formed so shallow that it does not reach the axis 1x of the sheath 1, as shown in FIG. 1, the base end position of the high-frequency electrode 2 is set to the stopper wall 5b from the position of the axis 1x of the sheath 1. Since the internal space 1b for deflecting the operation wire 3 by deflecting toward the rear end position 5e is sufficiently secured, the angle of the high-frequency electrode 2 can be greatly changed in a small space.

  In this way, the direction of the high-frequency electrode 2 can be arbitrarily changed by remote operation from the hand side using the operation wire 3 for projecting and retracting the high-frequency electrode 2. If the operating force for pushing 3 is loosened, the distal end portion of the operating wire 3 and the high-frequency electrode 2 return to the original straight state as shown in FIG.

  7 and 8 show an endoscope treatment tool according to a second embodiment of the present invention. As shown in FIG. 9, a plurality of (for example, a plurality of (for example, around) a core wire 3m as an operation wire 3 is shown. Using a stranded wire obtained by twisting 6 wires 3n, only the core wire 3m is extended forward at the frontmost portion, and the extended portion of the core wire 3m is used as the high-frequency electrode 2. Other parts are the same as those in the first embodiment.

  With this configuration, the strength of the waist of the operation wire 3 itself is not different between the vicinity of the distal end portion and the hand side, but there is no need to provide the connecting member 4 that becomes a rigid body, and the operation wire 3 is provided with the stopper wall. Since it can bend immediately after the contact part with 5b, the direction of the high frequency electrode 2 can be changed reliably.

It is side surface sectional drawing of the state from which the direction of the high frequency electrode of the front-end | tip part of the treatment tool for endoscopes of 1st Example of this invention changed. It is a top view which shows the whole structure of the treatment tool for endoscopes of the Example of this invention. It is side surface sectional drawing which shows the whole structure of the treatment tool for endoscopes of the Example of this invention. It is side surface sectional drawing of the front-end | tip part of the treatment tool for endoscopes of 1st Example of this invention. It is VV sectional drawing in FIG. 4 of the treatment tool for endoscopes of 1st Example of this invention. It is a perspective view in the state where the stopper member was separated from the sheath of the treatment tool for endoscopes of the 1st example of the present invention. It is side surface sectional drawing of the front-end | tip part of the treatment tool for endoscopes of the 2nd Example of this invention. It is side surface sectional drawing of the state from which the direction of the high frequency electrode of the front-end | tip part of the treatment tool for endoscopes of the 2nd Example of this invention changed. It is a perspective view of the front-end | tip part of the operation wire of the treatment tool for endoscopes of the 2nd Example of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Sheath 1b Internal space 2 High frequency electrode (tip treatment member)
DESCRIPTION OF SYMBOLS 3 Operation wire 3a Stranded wire 3b Flexible twisted wire 3m Core wire 3n Wire twisted around the core wire 4 Connection member 4a Stopper surface 5 Stopper member 5b Stopper wall

Claims (2)

The distal treatment member connected to the distal end of the manipulation wire is moved forward and backward in the axial direction by operating the manipulation wire inserted and removed in the sheath inserted into and removed from the treatment instrument insertion channel of the endoscope. An endoscopic treatment tool configured to project from
A stopper surface facing forward is formed in the vicinity of the connecting portion between the operation wire and the distal treatment member, and a stopper wall that abuts when the stopper surface moves forward is inclined with respect to the stopper surface so that the sheath Provided at the distal end portion, the operation wire is pushed forward from the proximal end side and the stopper surface is pressed against the stopper wall, so that the direction of the distal treatment member protruding from the distal end portion of the sheath is the stopper with respect to the stopper surface. In an endoscopic treatment tool that changes according to the inclination direction of the wall,
A treatment instrument for an endoscope, characterized in that the vicinity of the most distal portion of the operation wire is formed of a wire that is more flexible than a portion closer to the hand. The distal treatment member connected to the distal end of the manipulation wire is moved forward and backward in the axial direction by operating the manipulation wire inserted and removed in the sheath inserted into and removed from the treatment instrument insertion channel of the endoscope. An endoscopic treatment tool configured to project from
A stopper surface facing forward is formed in the vicinity of the connecting portion between the operation wire and the distal treatment member, and a stopper wall that abuts when the stopper surface moves forward is inclined with respect to the stopper surface so that the sheath Provided at the distal end portion, the operation wire is pushed forward from the proximal end side and the stopper surface is pressed against the stopper wall, so that the direction of the distal treatment member protruding from the distal end portion of the sheath is the stopper with respect to the stopper surface. In an endoscopic treatment tool that changes according to the inclination direction of the wall,
Using the stranded wire in which a plurality of wires are twisted around one core wire as the operation wire, only the core wire is extended forward at the most distal portion, and the tip treatment member is extended at the extended portion of the core wire. An endoscopic treatment tool characterized by being formed.

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