JP4996440B2 - Endoscopic high-frequency treatment instrument - Google Patents

Endoscopic high-frequency treatment instrument Download PDF

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JP4996440B2
JP4996440B2 JP2007321681A JP2007321681A JP4996440B2 JP 4996440 B2 JP4996440 B2 JP 4996440B2 JP 2007321681 A JP2007321681 A JP 2007321681A JP 2007321681 A JP2007321681 A JP 2007321681A JP 4996440 B2 JP4996440 B2 JP 4996440B2
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sheath
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conductive wire
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JP2009142416A (en
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貴明 舘林
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Hoya Corp
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Description

この発明は、内視鏡用高周波処置具に関する。   The present invention relates to an endoscopic high-frequency treatment instrument.

体腔内の表面粘膜の隆起部(隆起させた部分を含む)等を高周波焼灼して切開、剥離するための内視鏡用高周波処置具として、従来は、直線状又は曲線状の棒状の高周波電極を可撓性シースの先端から前方に突出配置したものや、内視鏡の先端フードの最先端部分に高周波電極になる導電線を横断的に配置したもの等が用いられている(例えば、特許文献1、2)。   Conventionally, a linear or curved rod-shaped high-frequency electrode has been used as a high-frequency treatment instrument for endoscopes for high-frequency cauterization and incision and separation of a raised portion (including a raised portion) of a surface mucosa in a body cavity. In which the wire is projected forward from the distal end of the flexible sheath, or the conductive wire that becomes a high-frequency electrode is disposed transversely at the most distal end portion of the distal end hood of the endoscope (for example, patents) References 1, 2).

しかし、棒状の高周波電極が突出配置された特許文献1に記載のものは高周波電極に幅が殆どないので剥離処置が不十分になり、内視鏡の先端フードを横断する高周波電極が設けられた特許文献2に記載のものは内視鏡に対する小回りがきかず使い難い等の問題がある。   However, the one described in Patent Document 1 in which a rod-shaped high-frequency electrode is protruded is insufficient in width because the high-frequency electrode has almost no width, and a high-frequency electrode that crosses the distal end hood of the endoscope is provided. The thing of patent document 2 has the problem that a small turn with respect to an endoscope does not work and it is difficult to use.

そこで、本願の発明者等は、図11に示されるように、先端付近に配置された先端シース91とそれより後方に配置された基側シース92の二つのシースを相対的に軸線周り方向に回転自在に接続して電気絶縁性の可撓性シースを構成し、先端シース91の最先端面を斜面状に形成して、その先端面を横断する状態に導電線からなる高周波電極93を配置した内視鏡用高周波処置具を創作して先に特許出願してある(特願2006−258317、図13等)。
特開2002−153485 特開2005−66140
Therefore, the inventors of the present application, as shown in FIG. 11, relatively move the two sheaths of the distal sheath 91 disposed near the distal end and the proximal sheath 92 disposed behind the distal sheath 91 in the direction around the axis. An electrically insulating flexible sheath is formed by being rotatably connected, the distal end surface of the distal end sheath 91 is formed in a slope shape, and a high-frequency electrode 93 made of a conductive wire is disposed across the distal end surface. An endoscopic high-frequency treatment instrument has been created and a patent application has been filed previously (Japanese Patent Application No. 2006-258317, FIG. 13 and the like).
JP 2002-153485 A JP-A-2005-66140

図11に示される内視鏡用高周波処置具は、経内視鏡的に(即ち、内視鏡の処置具挿通チャンネルに通して)体腔内の表面粘膜の隆起部等を高周波焼灼して切開しつつ剥離処置を行うのに適しており、先端シース91を基側シース92に対して任意に回転させることができるので、高周波電極93の向きを変える際などに小回りがきいて使い易い。   The endoscopic high-frequency treatment tool shown in FIG. 11 is transected endoscopically (that is, through the treatment tool insertion channel of the endoscope) by high-frequency cauterization of the raised portion of the surface mucosa in the body cavity. However, since the distal sheath 91 can be arbitrarily rotated with respect to the proximal sheath 92, it is easy to use with a small turn when changing the direction of the high-frequency electrode 93.

しかし、図11に示される内視鏡用高周波処置具は、高周波電極が小さいため、体腔内の表面粘膜の隆起部等を一気に切除するような処置を行うことができず、そのような処置を行う必要があるときは、何度にも分けて切除処置を行うか、さもなくば切除用の他の高周波処置具と使い分ける必要があり不便であった。   However, since the high-frequency treatment instrument for an endoscope shown in FIG. 11 has a small high-frequency electrode, it is not possible to perform a treatment such as removing a raised portion of a surface mucosa in a body cavity at a stretch. When it is necessary to perform the resection, it is inconvenient because it is necessary to perform the resection treatment several times or else to use it separately from other high-frequency treatment tools for resection.

本発明は、表面粘膜の隆起部等を経内視鏡的に高周波焼灼して切開しつつ剥離処置を行う処置と、一気に切除するような処置の双方を容易に行うことのできる内視鏡用高周波処置具を提供することを目的とする。   The present invention is for an endoscope capable of easily performing both a treatment for performing a peeling treatment while performing incision by high-frequency cauterization of a raised portion of a surface mucosa and a treatment for excision at a stroke. An object is to provide a high-frequency treatment instrument.

上記の目的を達成するため、本発明の内視鏡用高周波処置具は、内視鏡の処置具挿通チャンネルに挿脱される電気絶縁性の可撓性シースが、その先端付近に配置された先端シースとそれより後方に配置された基側シースの二つのシースを軸線周り方向に相対的に回転自在であるが軸線方向には相対的に進退できないように接続して構成され、先端シースの最先端面が斜面状に形成されると共に、その斜面が前方斜め上方向に向いた状態のときに先端シースの先端近傍の左右に位置する側壁に一対の透孔が形成されて、導電線からなる高周波電極が一対の透孔の間で先端シース外に出されて先端シースの最先端面に沿って配置され、導電線は、先端シースの最先端面に沿う領域の両端において後方に折り曲げられていて、一対の透孔を通って先端シース内から基側シース内に緩く引き通され、導電線を基端側から軸線方向に進退操作することにより高周波電極を先端シースの先端から前方に向かって突出させることができると共に、導電線を基端側から軸線周りに回転操作することにより先端シースを基側シースに対して軸線周り方向に回転させて先端シースの最先端面の向きを変えることができるようにしたものである。   In order to achieve the above object, in the endoscope high-frequency treatment instrument of the present invention, an electrically insulating flexible sheath that is inserted into and removed from the treatment instrument insertion channel of the endoscope is disposed near the distal end thereof. Two sheaths, a distal sheath and a proximal sheath disposed behind it, are connected so as to be relatively rotatable in the direction around the axis but not to move forward and backward in the axial direction. A pair of through-holes are formed on the left and right side walls in the vicinity of the distal end of the distal end sheath when the distal end surface is formed in a slope shape and the inclined surface faces obliquely upward in the forward direction. The high-frequency electrode is placed out of the distal sheath between the pair of through holes and disposed along the most distal surface of the distal sheath, and the conductive wire is bent backward at both ends of the region along the most distal surface of the distal sheath. Through the pair of through holes The high-frequency electrode can be protruded forward from the distal end of the distal sheath by moving the conductive wire forward and backward in the axial direction from the proximal end side while being pulled loosely from the sheath into the proximal sheath. By rotating the proximal sheath around the axis, the distal sheath can be rotated about the axial relative to the proximal sheath to change the direction of the most distal surface of the distal sheath.

なお、先端シースの最先端面から前方への高周波電極の最大突出量を規制するためのストッパが可撓性シース内に設けられていてもよい。   Note that a stopper for restricting the maximum protrusion amount of the high-frequency electrode forward from the most distal surface of the distal sheath may be provided in the flexible sheath.

本発明によれば、導電線が、先端シースの最先端面に沿う領域の両端において後方に折り曲げられていて、先端シースの先端近傍の側壁に形成された一対の透孔を通って先端シース内から基側シース内に軸線方向に進退自在に引き通され、その導電線を基端側から軸線方向に進退操作することにより高周波電極を先端シースの先端から前方に向かって突出させることができると共に、導電線を基端側から軸線周りに回転操作することにより先端シースを基側シースに対して軸線周り方向に回転させて先端シースの最先端面の向きを変えることができるので、表面粘膜の隆起部等を経内視鏡的に高周波焼灼して切開しつつ剥離処置を行う処置と、一気に切除するような処置の双方を容易に行うことができる。   According to the present invention, the conductive wire is bent backward at both ends of the region along the most distal surface of the distal sheath, and passes through the pair of through holes formed in the side wall near the distal end of the distal sheath. The high-frequency electrode can be projected forward from the distal end of the distal sheath by being retracted from the proximal end to the proximal sheath so as to be able to advance and retract in the axial direction and by operating the conductive wire in the axial direction from the proximal end side. By rotating the conductive wire around the axis from the proximal end side, the distal sheath can be rotated in the axial direction relative to the proximal sheath to change the direction of the most distal surface of the distal sheath. It is possible to easily perform both a treatment for performing a peeling treatment while performing incision by high-frequency cauterization of a raised portion and the like and a treatment for excision at a stroke.

内視鏡の処置具挿通チャンネルに挿脱される電気絶縁性の可撓性シースが、その先端付近に配置された先端シースとそれより後方に配置された基側シースの二つのシースを軸線周り方向に相対的に回転自在であるが軸線方向には相対的に進退できないように接続して構成され、先端シースの最先端面が斜面状に形成されると共に、その斜面が前方斜め上方向に向いた状態のときに先端シースの先端近傍の左右に位置する側壁に一対の透孔が形成されて、導電線からなる高周波電極が一対の透孔の間で先端シース外に出されて先端シースの最先端面に沿って配置され、導電線は、先端シースの最先端面に沿う領域の両端において後方に折り曲げられていて、一対の透孔を通って先端シース内から基側シース内に緩く引き通され、導電線を基端側から軸線方向に進退操作することにより高周波電極を先端シースの先端から前方に向かって突出させることができると共に、導電線を基端側から軸線周りに回転操作することにより先端シースを基側シースに対して軸線周り方向に回転させて先端シースの最先端面の向きを変えることができるようにしたものである。   An electrically insulating flexible sheath that is inserted into and removed from the treatment instrument insertion channel of the endoscope has two axes: a distal sheath disposed near the distal end and a proximal sheath disposed behind the distal sheath. The tip sheath surface is formed in a slanted shape, and the slant surface is inclined obliquely upward in the forward direction. A pair of through-holes are formed in the left and right side walls in the vicinity of the distal end of the distal sheath when facing, and the high-frequency electrode made of a conductive wire is brought out of the distal sheath between the pair of through-holes, and the distal sheath The conductive wire is bent rearward at both ends of the region along the distal end surface of the distal sheath and loosened from the distal sheath into the proximal sheath through a pair of through holes. Passed through and the conductive wire is on the proximal side The high-frequency electrode can be projected forward from the distal end of the distal sheath by moving forward and backward in the axial direction, and the distal sheath can be turned into the proximal sheath by rotating the conductive wire around the axial line from the proximal end side. On the other hand, it is possible to change the direction of the most distal surface of the distal sheath by rotating around the axis.

以下、図面を参照して本発明の実施例を説明する。
図2、図3及び図4は、本発明の第1の実施例の内視鏡用高周波処置具の先端付近の斜視図、平面断面図、及び側面部分断面図である。
Embodiments of the present invention will be described below with reference to the drawings.
2, 3, and 4 are a perspective view, a plan sectional view, and a side partial sectional view of the vicinity of the distal end of the endoscope high-frequency treatment device according to the first embodiment of the present invention.

各図に示される符号1,2は、図示されていない内視鏡の処置具挿通チャンネル内に挿脱される、例えば四フッ化エチレン樹脂チューブ等からなる直径が2mm程度の電気絶縁性の可撓性シースである。   Reference numerals 1 and 2 shown in each figure indicate an electrically insulative material having a diameter of about 2 mm made of, for example, an ethylene tetrafluoride resin tube that is inserted into and removed from a treatment instrument insertion channel of an endoscope (not shown). It is a flexible sheath.

そのうち、後方に配置された基側シース1は全長が例えば1〜2m程度の長いものであって、その先端側に配置された先端シース2は全長が数cm程度の短いものであり、先端シース2の方が基側シース1より細く形成されている。なお、基側シース1として、金属細線を一定の径で密着巻きして形成されたコイルパイプの外面に電気絶縁性チューブが被覆された構成のもの等を用いることもできる。   Among them, the proximal sheath 1 disposed on the rear side has a long length of about 1 to 2 m, for example, and the distal sheath 2 disposed on the distal side thereof has a short length of about several centimeters. Is formed thinner than the proximal sheath 1. In addition, as the base-side sheath 1, a structure in which an outer surface of a coil pipe formed by tightly winding a thin metal wire with a certain diameter is covered with an electrically insulating tube can be used.

基側シース1と先端シース2とは、相対的に軸線周り方向に回転自在であるが相対的に軸線方向に進退はできないように接続されている。3は、基側シース1と先端シース2とを接続するための電気絶縁性の硬質プラスチック等からなる接続管であり、接続管3の後半部を構成する細径部3aは基側シース1の先端内に差し込まれてそこに固定されている。   The proximal sheath 1 and the distal sheath 2 are connected so as to be relatively rotatable in the direction around the axis, but relatively incapable of moving back and forth in the axial direction. Reference numeral 3 denotes a connecting pipe made of electrically insulating hard plastic or the like for connecting the proximal sheath 1 and the distal sheath 2, and the small diameter portion 3 a constituting the latter half of the connecting pipe 3 is formed on the proximal sheath 1. It is inserted into the tip and fixed there.

接続管3の前半部内には、先端シース2の基端部分が軸線周り方向に回転自在であるが軸線方向には進退できないように緩く差し込み接続されている。具体的には、先端シース2側の外周面に突出形成された環状突起4が、接続管3側の内周面の全周に形成された円周溝5に係合することにより、その機能が発揮されている。なお、この実施例では環状突起4と円周溝5の断面形状が三角形状であるが円弧状や矩形状等であっても差し支えない。   The proximal end portion of the distal sheath 2 is loosely inserted and connected in the front half of the connecting tube 3 so as to be rotatable in the direction around the axis but not in the axial direction. Specifically, the annular projection 4 formed on the outer peripheral surface on the distal end sheath 2 side is engaged with a circumferential groove 5 formed on the entire circumference of the inner peripheral surface on the connecting tube 3 side, so that its function is achieved. Has been demonstrated. In this embodiment, the cross-sectional shapes of the annular protrusion 4 and the circumferential groove 5 are triangular, but they may be arcuate or rectangular.

先端シース2の最先端面2aは斜面状に形成されていて、その最も前方に位置する突端部2b付近には丸みが形成されている。そして、図4に示されるように、斜面状に形成されている最先端面2aが前方斜め上方向に向いた状態のときに先端シース2の先端近傍の左右に位置する側壁に一対の透孔6が形成されている。図5は、その部分の断面図(図4におけるV−V断面図)である。   The most distal surface 2a of the distal sheath 2 is formed in a slope shape, and a roundness is formed in the vicinity of the front end portion 2b located at the foremost side. Then, as shown in FIG. 4, a pair of through holes are formed in the side walls located on the left and right in the vicinity of the distal end of the distal sheath 2 when the foremost surface 2 a formed in a slope shape is directed obliquely upward in the forward direction. 6 is formed. FIG. 5 is a cross-sectional view (cross-sectional view taken along line VV in FIG. 4) of the portion.

そして、導電線からなる高周波電極7が一対の透孔6の間で先端シース2外に出されて、図2〜図4に示されるように、先端シース2の最先端面2aに沿って最先端面2aを横断する状態に配置されている。   Then, the high-frequency electrode 7 made of a conductive wire is brought out of the distal sheath 2 between the pair of through holes 6, and as shown in FIGS. 2 to 4, the highest frequency electrode 7 is formed along the most distal surface 2 a of the distal sheath 2. It arrange | positions in the state which crosses the front end surface 2a.

高周波電極7を構成する導電線は、先端シース2の最先端面2aに沿う領域の両端において略直角に後方に折り曲げられ、一対の透孔6を通って先端シース2内から基側シース1内に緩く引き通されている。8は、可撓性シース1,2内に位置する導電線である。   The conductive wire constituting the high-frequency electrode 7 is bent backward at a substantially right angle at both ends of the region along the distal end surface 2a of the distal sheath 2 and passes through the pair of through holes 6 from the distal sheath 2 to the proximal sheath 1. Has been pulled through loosely. Reference numeral 8 denotes a conductive wire located in the flexible sheaths 1 and 2.

なお、透孔6は、その部分だけが図6に拡大図示されるように、先端シース2外から先端シース2内に斜め後方に向けて形成されており、その傾斜角度θが小さいほど高周波電極7(導電線8)がスムーズに透孔6を通過することができる。   Note that the through-hole 6 is formed so as to be obliquely rearward from the distal sheath 2 into the distal sheath 2 as shown only in an enlarged view in FIG. 6, and the higher the tilt angle θ, the higher the frequency electrode. 7 (conductive wire 8) can pass through the through hole 6 smoothly.

ただし、傾斜角度θをあまり小さく形成すると先端シース2に肉薄のいわゆるペラペラな部分ができてしまうので、傾斜角度θは15〜45°程度の範囲にあるのが望ましく、20〜35°程度の範囲にあればより好ましい。その結果、透孔6の出口開口を図4に示されるように外側から見ると、楕円形又は卵形のようになっている。   However, if the inclination angle θ is formed too small, a thin so-called flared portion is formed on the distal sheath 2, so the inclination angle θ is preferably in the range of about 15 to 45 °, and is preferably in the range of about 20 to 35 °. Is more preferable. As a result, when the outlet opening of the through hole 6 is viewed from the outside as shown in FIG. 4, it has an elliptical shape or an oval shape.

また、図6に示されるように、透孔6の開口縁のうち少なくとも高周波電極7(導電線8)が押し付けられる部分6a,6bは滑らかなアール状に形成されており、それによっても高周波電極7(導電線8)がスムーズに透孔6を通過することができる。   Further, as shown in FIG. 6, at least the portions 6a and 6b to which the high-frequency electrode 7 (conductive wire 8) is pressed are formed in a smooth round shape in the opening edge of the through-hole 6, and accordingly, the high-frequency electrode 7 (conductive wire 8) can pass through the through hole 6 smoothly.

図7は内視鏡用高周波処置具の全体構成を示しており、基側シース1の基端は操作部10に連結されている。基側シース1の基端に連結された操作部本体11の手元側端部には固定指掛け12が取り付けられ、可動指掛け13が操作部本体11に対して軸線周り方向に進退操作自在且つ軸線方向に進退操作自在に取り付けられている。   FIG. 7 shows the overall configuration of the endoscope high-frequency treatment instrument, and the proximal end of the proximal sheath 1 is connected to the operation unit 10. A fixed finger hook 12 is attached to the proximal end of the operation section main body 11 connected to the proximal end of the base sheath 1, and the movable finger hook 13 can be moved forward and backward in the direction around the axis with respect to the operation section main body 11. It is attached to the head so that it can be moved forward and backward.

可動指掛け13には、導電線8の基端が連結固定されると共に、図示されていない高周波電源コードが接続される接続端子14が配置されており、その接続端子14に高周波電源コードを接続することにより、導電線8を経由して高周波電極7に高周波電流を通電することができる。   A connection terminal 14 to which a base end of the conductive wire 8 is connected and fixed and a high-frequency power cord (not shown) is connected is arranged on the movable finger hook 13, and the high-frequency power cord is connected to the connection terminal 14. Thus, a high-frequency current can be applied to the high-frequency electrode 7 via the conductive wire 8.

このような構成により、図7に矢印Aで示されるように可動指掛け13を先端方向に移動させる操作を行うと、それにより導電線8が先端側へ移動して、図1に矢印Yで示されるように、高周波電極7が先端シース2の先端から前方に向かって突出する。   With such a configuration, when the operation of moving the movable finger hook 13 in the distal direction is performed as indicated by an arrow A in FIG. 7, the conductive wire 8 is thereby moved toward the distal end, and the arrow Y in FIG. As shown, the high-frequency electrode 7 projects forward from the distal end of the distal sheath 2.

したがって、その状態では高周波電極7が前後方向に長く伸びた状態になっているので、体腔内の表面粘膜の隆起部等を一気に切除するような処置を容易に行うことができる。
また、可動指掛け13を固定指掛け12に引き寄せる方向に移動させる操作を行うと、図2に示されるように高周波電極7が先端シース2の最先端面2aに沿う状態に戻るので、表面粘膜の隆起部等を高周波焼灼して切開しつつ剥離を行うような処置を容易に行うことができる。
Therefore, in this state, the high-frequency electrode 7 is in a state of being elongated in the front-rear direction, so that it is possible to easily perform a treatment such as removing the raised portion of the surface mucosa in the body cavity at once.
Further, when an operation for moving the movable finger hook 13 in the direction to draw the fixed finger hook 12 is performed, the high-frequency electrode 7 returns to the state along the most distal surface 2a of the distal sheath 2 as shown in FIG. It is possible to easily perform a treatment such as peeling while performing incision by high-frequency cauterization of a part or the like.

また、図7に矢印Bで示されるように可動指掛け13を軸線周りに回転させる操作を行うと、それにより導電線8が軸線周りに回転して、図1に矢印Zで示されるように、先端シース2が基側シース1に対し軸線周り方向に回転する。したがって、高周波電極7の向きを小回りのきく状態で任意に制御して、切開、剥離等の各処置を正確に容易に行うことができる。   Further, when the operation of rotating the movable finger hook 13 around the axis as shown by the arrow B in FIG. 7 is performed, the conductive wire 8 rotates around the axis, and as shown by the arrow Z in FIG. The distal sheath 2 rotates in the direction around the axis with respect to the proximal sheath 1. Therefore, the direction of the high-frequency electrode 7 can be arbitrarily controlled in a state where the high-frequency electrode 7 is slightly turned, and each treatment such as incision and peeling can be accurately and easily performed.

図8は、本発明の第2の実施例の内視鏡用高周波処置具を示しており、先端シース2からその前方への高周波電極7の最大突出量を規制するためのストッパ9が基側シース1内に設けられている。その他の構成は前述の第1の実施例と同じである。   FIG. 8 shows an endoscopic high-frequency treatment instrument according to a second embodiment of the present invention, in which a stopper 9 for restricting the maximum protruding amount of the high-frequency electrode 7 from the distal sheath 2 to the front thereof is a base side. It is provided in the sheath 1. Other configurations are the same as those in the first embodiment.

ストッパ9は、導電線8に固定された硬質部材であり、導電線8が前方に移動すると、図9に示されるようにストッパ9が接続管3の後端面に当接して、それ以上の前方への移動が規制される。このようにすることにより、先端シース2の最先端面2aからその前方への高周波電極7の過剰突出が規制されて安全性が確保される。なお、ストッパ9を先端シース2内に配置してもよい。   The stopper 9 is a hard member fixed to the conductive wire 8, and when the conductive wire 8 moves forward, the stopper 9 abuts against the rear end surface of the connecting pipe 3 as shown in FIG. Movement to is regulated. By doing in this way, the excessive protrusion of the high frequency electrode 7 from the front-end | tip surface 2a of the front-end | tip sheath 2 to the front is controlled, and safety | security is ensured. Note that the stopper 9 may be disposed in the distal sheath 2.

図10は、本発明の第3の実施例の内視鏡用高周波処置具を示しており、接続管3の外周面の先端近傍の領域3bを、先細りの滑らかなテーパ状に形成したものである。その他の構成は第1の実施例と同じである。このように構成することにより、内視鏡観察画面において高周波電極7が接続管3により遮られ難くなって、使い易くなる。   FIG. 10 shows a high-frequency treatment instrument for an endoscope according to a third embodiment of the present invention, in which a region 3b in the vicinity of the distal end of the outer peripheral surface of the connecting tube 3 is formed in a tapered and tapered shape. is there. Other configurations are the same as those of the first embodiment. With this configuration, the high-frequency electrode 7 is not easily blocked by the connecting pipe 3 on the endoscope observation screen, and is easy to use.

本発明の第1の実施例の内視鏡用高周波処置具の先端付近の斜視図である。It is a perspective view near the front-end | tip of the high frequency treatment tool for endoscopes of 1st Example of this invention. 本発明の第1の実施例の内視鏡用高周波処置具の先端付近の斜視図である。It is a perspective view near the front-end | tip of the high frequency treatment tool for endoscopes of 1st Example of this invention. 本発明の第1の実施例の内視鏡用高周波処置具の先端付近の平面断面図である。It is a plane sectional view near the front-end | tip of the high frequency treatment tool for endoscopes of 1st Example of this invention. 本発明の第1の実施例の内視鏡用高周波処置具の先端部分の側面部分断面図である。It is side surface partial sectional drawing of the front-end | tip part of the high frequency treatment tool for endoscopes of 1st Example of this invention. 本発明の第1の実施例の内視鏡用高周波処置具の図4におけるV−V断面図である。FIG. 5 is a cross-sectional view of the endoscope high-frequency treatment tool according to the first embodiment of the present invention taken along line VV in FIG. 本発明の第1の実施例の内視鏡用高周波処置具の部分拡大平面断面図である。It is a partial expanded plane sectional view of the high frequency treatment tool for endoscopes of the 1st example of the present invention. 本発明の第1の実施例の内視鏡用高周波処置具の全体構成の側面図である。It is a side view of the whole structure of the high frequency treatment tool for endoscopes of the 1st example of the present invention. 本発明の第2の実施例の内視鏡用高周波処置具の先端付近の平面部分断面図である。It is a plane fragmentary sectional view near the front-end | tip of the high frequency treatment tool for endoscopes of the 2nd Example of this invention. 本発明の第2の実施例の内視鏡用高周波処置具の先端付近の平面部分断面図である。It is a plane fragmentary sectional view near the front-end | tip of the high frequency treatment tool for endoscopes of the 2nd Example of this invention. 本発明の第3の実施例の内視鏡用高周波処置具の先端付近の平面断面図である。It is plane sectional drawing of the front-end | tip vicinity of the high frequency treatment tool for endoscopes of the 3rd Example of this invention. 従来の内視鏡用高周波処置具の先端付近の斜視図である。It is a perspective view near the front-end | tip of the conventional high frequency treatment tool for endoscopes.

符号の説明Explanation of symbols

1,2 可撓性シース
1 基側シース
2 先端シース
2a 最先端面
3 接続管
6 透孔
7 高周波電極
8 導電線
9 ストッパ
10 操作部
DESCRIPTION OF SYMBOLS 1, 2 Flexible sheath 1 Proximal sheath 2 Tip sheath 2a Most advanced surface 3 Connection pipe 6 Through-hole 7 High frequency electrode 8 Conductive wire 9 Stopper 10 Operation part

Claims (2)

内視鏡の処置具挿通チャンネルに挿脱される電気絶縁性の可撓性シースが、その先端付近に配置された先端シースとそれより後方に配置された基側シースの二つのシースを軸線周り方向に相対的に回転自在であるが軸線方向には相対的に進退できないように接続して構成され、
上記先端シースの最先端面が斜面状に形成されると共に、その斜面が前方斜め上方向に向いた状態のときに上記先端シースの先端近傍の左右に位置する側壁に一対の透孔が形成されて、
導電線からなる高周波電極が上記一対の透孔の間で上記先端シース外に出されて上記先端シースの最先端面に沿って配置され、
上記導電線は、上記先端シースの最先端面に沿う領域の両端において後方に折り曲げられていて、上記一対の透孔を通って上記先端シース内から上記基側シース内に緩く引き通され、
上記導電線を基端側から軸線方向に進退操作することにより上記高周波電極を上記先端シースの先端から前方に向かって突出させることができると共に、上記導電線を基端側から軸線周りに回転操作することにより上記先端シースを上記基側シースに対して軸線周り方向に回転させて上記先端シースの最先端面の向きを変えることができるようにしたことを特徴とする内視鏡用高周波処置具。
An electrically insulating flexible sheath that is inserted into and removed from the treatment instrument insertion channel of the endoscope has two axes: a distal sheath disposed near the distal end and a proximal sheath disposed behind the distal sheath. It is configured to be connected so as to be relatively rotatable in the direction but not to be relatively advanced and retracted in the axial direction.
The distal end surface of the tip sheath is formed in a slope shape, and a pair of through holes are formed in the side walls located on the left and right in the vicinity of the tip end of the tip sheath when the slope surface is inclined forward and upward. And
A high-frequency electrode made of a conductive wire is placed outside the tip sheath between the pair of through holes and disposed along the most distal surface of the tip sheath,
The conductive wire is bent backward at both ends of the region along the most distal surface of the distal sheath, and is loosely drawn from the distal sheath through the pair of through holes into the proximal sheath,
The high-frequency electrode can be protruded forward from the distal end of the distal sheath by moving the conductive wire in the axial direction from the proximal end side, and the conductive wire is rotated around the axial line from the proximal end side. In this way, the distal sheath can be rotated in the direction around the axis with respect to the proximal sheath so that the direction of the most distal surface of the distal sheath can be changed. .
上記先端シースの最先端面から前方への上記高周波電極の最大突出量を規制するためのストッパが上記可撓性シース内に設けられている請求項1記載の内視鏡用高周波処置具。   The high-frequency treatment instrument for an endoscope according to claim 1, wherein a stopper for restricting the maximum protrusion amount of the high-frequency electrode forward from the most distal surface of the distal sheath is provided in the flexible sheath.
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