JP4889827B2 - 内視鏡用処置具 - Google Patents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
- A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/0034—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means adapted to be inserted through a working channel of an endoscope
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- A61B2017/2926—Details of heads or jaws
- A61B2017/2932—Transmission of forces to jaw members
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- A61B2018/00083—Electrical conductivity low, i.e. electrically insulating
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00107—Coatings on the energy applicator
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- A—HUMAN NECESSITIES
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- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00107—Coatings on the energy applicator
- A61B2018/00136—Coatings on the energy applicator with polymer
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00595—Cauterization
Description
本願は、2009年9月15日に、日本に出願された特願2009−212942号に基づき優先権を主張し、その内容をここに援用する。
処置具の一例として、特許文献1に記載の鉗子が知られている。この鉗子では、回動軸を介して互いに相対回動可能に支持された一対の鉗子部材が先端に設けられている。
これにより、操作部を介して操作ワイヤを軸線方向に進退させることで一対の鉗子部材を回動軸回りに相対回動させて開閉させることができる。
本発明は上記事情に鑑みて成されたものであり、鉗子部材の開閉動作を安定して行うことができる内視鏡用処置具を提供することを目的とする。
また、本発明の一態様の内視鏡用処置具は、鉗子回動軸によって相対回動可能に支持された一対の鉗子部材と、前記一対の鉗子部材の開閉操作を行うための操作部と、前記一対の鉗子部材と前記操作部とを接続する操作ワイヤと、前記操作ワイヤの先端部に設けられ、少なくとも一つのリンク回動軸を有する接続部材と、第一の端部が前記一対の鉗子部材の各々の基端部に回動可能に連結され、第二の端部が前記リンク回動軸に回動可能に連結された一対のリンク部材と、前記接続部材及び前記操作ワイヤの、前記鉗子回動軸に対する相対移動の方向を規制する規制部と、を備え、前記接続部材は、前記操作ワイヤの軸線と平行に形成された溝を有し、前記規制部は、前記溝と係合することによって前記接続部材及び前記操作ワイヤの前記相対移動の方向を前記操作ワイヤの軸線と平行に規制する。
また、前記一対の鉗子部材の少なくとも一方は、通電可能な電極部と、前記電極部の少なくとも一部を被覆するように取り付けられた絶縁部とを有し、前記規制ワイヤの第一の端部は前記電極部に電気的に接続され、前記規制ワイヤの第二の端部は電源に接続されてもよい。
各リンク部材35、36の先端側は、それぞれ第1鉗子部材11及び第2鉗子部材12の基端側に回動可能に連結されている。一対の鉗子部材11、12が閉じられた状態において、各リンク部材35、36は互いに平行となるように設定されている。
コイルシース41は、公知の各種のものを適宜選択して採用することができる。コイルシース41の先端にはカバー14が取り付けられ、基端は操作部20の本体部21に固定されている。
まず、患者の体内に図示しない内視鏡を挿入し、処置対象の体腔内組織(対象組織)付近まで内視鏡の先端を進める。
これを防ぐ一つの方法として、リンク部材の回動軸を有し、操作ワイヤの先端に設けられた接続部材の、操作ワイヤの軸線方向における寸法を長く設定することが考えられる。しかしながら、この場合は、実質的に可撓性を有さない領域の長さ(以下、「硬質長」と称する。)が処置具の先端側において長くなるという問題がある。硬質長が長くなると、内視鏡が体腔内で蛇行等している場合に、処置具を内視鏡のチャンネル内に挿入しにくくなり、処置具の挿抜に大きな力量が必要となることがある。
従来の処置具においては、コイルシース41とチューブシース42とを相対回転可能に接続する構造は、チューブシースの先端付近に設けられることが多く、その結果、処置具先端の硬質長が長くなり、鉗子チャンネルへの挿入が困難となったり、内視鏡に対する挿抜に大きな力量が必要となったりする等の問題があった。本実施形態の処置具1の挿入部40の構造は、これを解決するものである。
なお、以降の説明において、既に説明した各実施形態の処置具と共通する構成については、同一の符号を付して、重複する説明を省略する。
図8は、処置具51の処置部60周辺を、カバー14を除いて示す図である。処置部60は、一対の鉗子部材11、12に代えて、第1鉗子部材61及び第2鉗子部材62を備えている。
なお、このような構成に代えて、ステンレス等の金属で構成されたコアの表面すべてを上述の絶縁性部材や絶縁コーティング等により被覆して第2鉗子部材62が形成されてもよい。
上記のような構造により、規制ワイヤ71の先端は、鉗子回動軸65に対して回動自在に取り付けられ、かつ第1鉗子部材61の電極部63にのみ高周波電流を供給可能となっている。また、図8に示すように、リンク回動軸34A、34Bの軸線方向から見たときに、規制ワイヤ71は、第1リンク部材35と第2リンク部材36との間に位置するように配置されており、規制ワイヤ71と各リンク部材35、36とが重ならない位置関係となっている。
上述した各構造により、処置具51は、全体としてモノポーラ(単極子型)の高周波処置具に構成されている。
まず、図示しない公知の対極板と接触させた患者の体内に、図示しない内視鏡を挿入し、処置対象の体腔内組織付近まで内視鏡の先端を進める。そして、第1実施形態の処置具1と同様の手順で処置部60を鉗子チャンネルから突出させた後、図示しない高周波電源とプラグ53とを図示しない電源ケーブルで接続する。
処置終了後、使用者は、処置具51を鉗子チャンネルから抜去し、かつ、内視鏡を体外へ抜去させて手技を終了する。
なお、この場合、リング部材45Aとストッパリング46との寸法関係を逆転させ、ストッパリング46がチューブシースに圧入され、リング部材45Aがコイルシース41に固定されるようにしてもよい。
このとき、突起14A及び溝34Aが、片側に一組だけ設けられてもよい。
また、2つのリンク回動軸に連結された一対のリンク部材が、一対の鉗子部材が閉じられた状態において交差するように配置されてもよい。
これらの場合、規制ワイヤの先端を鉗子回動軸に連結させにくくなるので、鉗子回動軸よりも操作部側の位置で、規制ワイヤの先端をカバー14等に固定してもよい。
11、61 第1鉗子部材
12、62、91 第2鉗子部材
13、65、94 鉗子回動軸
20 操作部
31 操作ワイヤ
33 規制ワイヤ(規制部)
34 接続部材
34A、34B リンク回動軸
34C 溝
35 第1リンク部材
36 第2リンク部材
63、92 電極部
64、93 絶縁部
71、71A、71B 規制ワイヤ
X1 軸線
Claims (4)
- 鉗子回動軸によって相対回動可能に支持された一対の鉗子部材と、
前記一対の鉗子部材の開閉操作を行うための操作部と、
前記一対の鉗子部材と前記操作部とを接続する操作ワイヤと、
前記操作ワイヤの先端部に設けられ、少なくとも一つのリンク回動軸を有する接続部材と、
第一の端部が前記一対の鉗子部材の各々の基端部に回動可能に連結され、第二の端部が前記リンク回動軸に回動可能に連結された一対のリンク部材と、
前記一対のリンク部材が前記リンク回動軸回りに回動する際に前記一対のリンク部材の開閉方向の内側に向けられる面であって前記一対のリンク部材の少なくとも一方の前記面に当接可能であるとともに、前記接続部材及び前記操作ワイヤの前記鉗子回動軸に対する相対移動の方向を規制する規制部と、
を備え、
前記接続部材は、前記操作ワイヤの軸線と平行に形成された溝を有し、
前記規制部は、前記溝と係合することによって前記接続部材及び前記操作ワイヤの前記相対移動の方向を規制し、且つ、前記一対のリンク部材が前記規制部に近接する方向において、前記一対のリンク部材が前記規制部に当接する位置を越えるような前記一対のリンク部材の回動を規制することを特徴とする内視鏡用処置具。 - 鉗子回動軸によって相対回動可能に支持された一対の鉗子部材と、
前記一対の鉗子部材の開閉操作を行うための操作部と、
前記一対の鉗子部材と前記操作部とを接続する操作ワイヤと、
前記操作ワイヤの先端部に設けられ、少なくとも一つのリンク回動軸を有する接続部材と、
第一の端部が前記一対の鉗子部材の各々の基端部に回動可能に連結され、第二の端部が前記リンク回動軸に回動可能に連結された一対のリンク部材と、
前記接続部材及び前記操作ワイヤの、前記鉗子回動軸に対する相対移動の方向を規制する規制部と、
を備え、
前記接続部材は、前記操作ワイヤの軸線と平行に形成された溝を有し、
前記規制部は、前記溝と係合することによって前記接続部材及び前記操作ワイヤの前記相対移動の方向を前記操作ワイヤの軸線と平行に規制する内視鏡用処置具。 - 前記規制部は、前記操作ワイヤの軸線と平行に配置された規制ワイヤである請求項1または2に記載の内視鏡用処置具。
- 前記一対の鉗子部材の少なくとも一方は、通電可能な電極部と、前記電極部の少なくとも一部を被覆するように取り付けられた絶縁部とを有し、
前記規制ワイヤの第一の端部は前記電極部に電気的に接続され、前記規制ワイヤの第二の端部は電源に接続される請求項3に記載の内視鏡用処置具。
Priority Applications (1)
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JP2011511924A JP4889827B2 (ja) | 2009-09-15 | 2010-08-04 | 内視鏡用処置具 |
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Application Number | Priority Date | Filing Date | Title |
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JP2009212942 | 2009-09-15 | ||
JP2009212942 | 2009-09-15 | ||
PCT/JP2010/063182 WO2011033874A1 (ja) | 2009-09-15 | 2010-08-04 | 内視鏡用処置具 |
JP2011511924A JP4889827B2 (ja) | 2009-09-15 | 2010-08-04 | 内視鏡用処置具 |
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JP4889827B2 true JP4889827B2 (ja) | 2012-03-07 |
JPWO2011033874A1 JPWO2011033874A1 (ja) | 2013-02-14 |
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US (1) | US8551086B2 (ja) |
EP (1) | EP2478854B8 (ja) |
JP (1) | JP4889827B2 (ja) |
CN (1) | CN102470002B (ja) |
WO (1) | WO2011033874A1 (ja) |
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