JP5288953B2 - Endoscopic treatment tool - Google Patents

Description

  The present invention relates to an endoscope treatment tool.

  The endoscope treatment tool is projected and retracted from the distal end of the flexible sheath to the distal end of the operation member that is inserted and disposed in the flexible sheath so as to be movable forward and backward in the axial direction and rotatable in the direction around the axial line. In many cases, the distal end treatment member that can be rotated around the axis is connected.

  In such an endoscope treatment tool, the distal treatment member is rotated by an arbitrary angle in the direction around the axis at the distal end of the flexible sheath, whereby the orientation of the distal treatment member with respect to the affected area or the like to be treated is changed. The treatment can be easily and reliably performed by setting the most preferable desired direction.

  However, if the distal treatment member always rotates freely at the distal end of the flexible sheath, it is difficult to maintain the preferred orientation, so the stopper provided on the flexible sheath side There is a stopper receiving portion that comes into contact with and separates from the operating member, and the operation member advances and retracts in conjunction with the rotation restriction of the distal treatment member (for example, Patent Document 1).

In the invention described in Patent Document 1, the rotation receiving position where the stopper receiving portion abuts against the stopper and the rotation of the distal treatment member is suppressed as the operation member advances and retreats in the axial direction, and the stopper receiving portion is the stopper. The stopper receiving portion is moved to a suppression release position where the distal treatment member can be rotated in the direction around the axis with respect to the flexible sheath.
JP2004-261372

  In the invention described in Patent Document 1, a stopper member formed in an elongated cylindrical shape is connected and fixed to the distal end of the flexible sheath. However, in such a configuration, there is a possibility that the stopper member may come off from the flexible sheath, and when trying to make such a configuration, the stopper member which is the distal end hard portion of the treatment instrument becomes long, Inconveniences such as failure of smooth insertion / removal of the endoscope into / from the treatment instrument insertion channel occur.

  The present invention can perform treatment easily and reliably by interlocking the advance / retreat operation of the operation member and the rotation restriction of the distal treatment member, and may be deformed or dropped so that the distal end hard portion length does not become longer. It is an object of the present invention to provide an endoscopic treatment tool capable of effectively providing a stopper without a gap.

In order to achieve the above object, the endoscope treatment tool of the present invention is operated at the distal end of an operation member that is inserted and disposed in a flexible sheath so as to be movable forward and backward in the axial direction and rotatable in the direction around the axial line. A distal treatment member that protrudes and retracts from the distal end of the flexible sheath by the advancement / retraction operation of the member and rotates in the direction around the axis of the flexible sheath by the rotational operation of the operation member is connected and provided on the flexible sheath side. A stopper receiving portion that comes into contact with and away from the stopper is provided on the operation member. As the operation member advances and retracts in the axial direction, the stopper receiving portion contacts the stopper and the rotation of the distal treatment member is suppressed. An internal view in which the stopper receiving portion is movably provided at the rotation suppressing position and the suppression releasing position where the stopper receiving portion is separated from the stopper and the distal treatment member is rotatable about the axis with respect to the flexible sheath. Mirror processing In the device, at least the distal end portion of the flexible sheath is formed of a flexible tube, and a constricted portion protruding inward is formed therein, and the constricted portion is flexible so that the inner diameter of the constricted portion does not widen. A fastening ring made of a rigid material that is tightened from the outer periphery of the tube is fixedly attached to the flexible tube, and the inner wall rear end wall portion of the constricted portion serves as a stopper, and the flexible tube is electrically insulated. The operation member and the distal treatment member are each formed of a conductive material, and a high-frequency current can be supplied to the distal treatment member via the operation member. The fastening ring covering ring made of an electrically insulating material covers the outer surface of the fastening ring and is hidden from the outer peripheral surface of the flexible tube so as not to protrude outward from the outer periphery of the flexible tube. Install in condition It is what is.

  In addition, both the cross-sectional shape of the inner surface of the constricted portion and the cross-sectional shape of the tightening ring may be circular, and the tightening wheel reduces the diameter of a metal ring having a C-shaped cross-sectional shape at the outer periphery of the constricted portion. It may be formed by welding the cut in a state where there is no gap in the C-shaped cut.

  Further, the cross-sectional shape of the fastening ring may be non-circular, and the cross-sectional shape of the inner surface of the constricted portion may be formed in a non-circular shape corresponding to the fastening ring.

Further, the fastening ring covering ring may be a heat shrinkable tube .

Moreover, the width | variety of the clamp ring in the longitudinal direction of a flexible tube and the clamp ring covering ring may be formed in the same width .

  According to the present invention, at least the distal end portion of the flexible sheath is formed of a flexible tube, and a constricted portion protruding inward is formed therein, and the constricted portion is formed so that the inner diameter of the constricted portion does not widen. A fastening ring made of a rigid material to be tightened from the outer peripheral side of the flexible tube is fixedly attached to the flexible tube, and the inner rear end wall portion of the constricted portion serves as a stopper. The stopper can be easily and reliably operated in conjunction with the forward / backward movement of the distal end and the rotation restriction of the distal end treatment member, and a stopper that does not cause deformation or dropout is effectively provided so that the distal end hard portion length does not become longer. be able to.

  The operation member protrudes and retracts from the distal end of the flexible sheath by the advancement / retraction operation of the operation member and is inserted into the flexible sheath so as to be movable forward and backward in the axial direction and rotatable in the direction around the axis. A distal end treatment member that rotates in the direction around the axis of the flexible sheath is connected by a rotation operation, and a stopper receiving portion that comes in contact with and separates from a stopper provided on the flexible sheath side is provided on the operation member. As the operation member advances and retreats in the axial direction, the stopper receiving portion abuts against the stopper and the rotation of the distal treatment member is suppressed, and the stopper receiving portion is separated from the stopper and the distal treatment member is flexible. In the endoscope treatment tool in which the stopper receiving portion is movably provided at the suppression release position that is rotatable in the direction around the axis with respect to the conductive sheath, at least the distal end portion of the flexible sheath is flexible. A tightening ring formed of a tube and formed of a rigid material in which a constricted portion protruding inward is formed, and the constricted portion is tightened from the outer peripheral side of the flexible tube so that the inner diameter of the constricted portion does not widen. Is fixedly attached to the flexible tube, and the inner surface rear end wall portion of the constricted portion serves as a stopper.

Embodiments of the present invention will be described below with reference to the drawings.
FIG. 3 shows the overall configuration of the endoscope treatment tool according to the first embodiment of the present invention.
Reference numeral 1 denotes an electrically insulating flexible sheath formed in an elongated cylindrical shape by a flexible tube such as a tetrafluoroethylene resin tube, for example, in a treatment instrument insertion channel of an endoscope (not shown) Is inserted and removed. The diameter of the flexible sheath 1 is, for example, about 2 mm, and the length is, for example, about 1.5-2 m.

  In this embodiment, the flexible sheath 1 is formed of a single flexible tube over its entire length. However, in the present invention, at least the distal end portion of the flexible sheath 1 is formed of a flexible tube. It only has to be.

  Reference numeral 2 denotes a distal treatment member protruding from the distal end of the flexible sheath 1, and the distal treatment member 2 of this embodiment is formed in a hook shape that is used for incision of a mucous membrane when energized with a high-frequency current. It is a conductive high frequency electrode. However, the distal treatment member 2 may have any other shape.

  In the flexible sheath 1, a conductive operation wire 3 (operation member) made of, for example, a stainless steel stranded wire is inserted and disposed so as to be movable forward and backward in the axial direction and rotatable in the direction around the axial line. The distal treatment member 2 is connected to the distal end of the head.

  As a result, when the operation wire 3 advances and retreats in the axial direction within the flexible sheath 1, the distal treatment member 2 protrudes and retracts from the distal end of the flexible sheath 1, and the operation wire 3 rotates around the axis within the flexible sheath 1. When rotated in the direction, the distal treatment member 2 rotates in the direction around the axis at the distal end portion of the flexible sheath 1.

  An operation unit 10 is connected to the proximal end of the flexible sheath 1 for performing an operation of moving the operation wire 3 forward and backward and rotating with respect to the flexible sheath 1. A slide operation member 12 is slidably attached to the operation portion main body 11 formed in the same direction as the proximal end portion of the flexible sheath 1 (but not to rotate with respect to the operation portion main body 11). ing.

  The base end of the operation wire 3 is connected and fixed to the slide operation member 12. Therefore, by sliding the slide operation member 12 as indicated by the arrow A, the operation wire 3 moves forward and backward within the flexible sheath 1, and the distal treatment member 2 is allowed as indicated by the arrow B. The flexible sheath 1 projects from the tip.

  In addition, 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 distal treatment member 2 via the operation wire 3.

  A rotation holding ring 15 connected and fixed to the proximal end of the flexible sheath 1 is engaged with the most distal portion of the operation unit 10 so as to be rotatable in the direction around the axis. Therefore, as indicated by the arrow C, the operation wire 3 is rotated in the flexible sheath 1 by rotating the operation portion main body 11 and the slide operation member 12 integrally with respect to the rotation holding ring 15 in the direction around the axis. Then, as indicated by an arrow D, a rotational force in the direction around the axis is applied to the distal treatment member 2 at the distal position of the flexible sheath 1.

  1 and 2 show the distal end portion of the endoscope treatment tool, FIG. 1 shows a state in which the distal treatment member 2 protrudes from the distal end of the flexible sheath 1, and FIG. Is drawn into the distal end of the flexible sheath 1.

  The distal treatment member 2 and the operation wire 3 are connected via a metal connecting member 4 having a cylindrical pipe-like conductivity, as shown in an exploded view in FIG. Specifically, the rear end protruding portion 2a formed to protrude from the tail portion of the distal treatment member 2 and the distal end portion of the operation wire 3 are inserted into the connecting member 4 from the front and rear, and are integrally connected and fixed by brazing or the like. Has been.

  Such a connecting member 4 constitutes an “operation member” together with the operation wire 3, but the outer diameter is formed large only in the vicinity of the rear end, and the portion where the outer diameter changes is a taper of about 30 ° to 60 °. It is formed in a planar shape, and its inclined surface is a stopper receiving portion 9 described later.

  Returning to FIGS. 1 and 2, a constricted portion 5 that protrudes inward is formed in the vicinity of the distal end of the flexible sheath 1 formed of a flexible tube, and the inner diameter of the portion is reduced. . The inner diameter of the constricted portion 5 is formed such that a portion where the outer diameter of the connecting member 4 is thin passes without resistance, but a portion where the outer diameter of the connecting member 4 is thick cannot pass.

  Then, the tightening ring 6 made of a rigid material such as stainless steel for tightening the constricted portion 5 from the outer peripheral side of the flexible sheath 1 is flexible so that the inner diameter of the constricted portion 5 does not widen. It is fixedly attached to the sheath 1. The fastening ring 6 is attached in a state of being hidden from the outer peripheral surface of the flexible sheath 1 so as not to protrude outward from the outer periphery of the flexible sheath 1.

  For example, as shown in FIG. 5, such a constricted portion 5 is obtained by first covering the outer periphery of a flexible sheath 1 made of a flexible tube with a metal ring 6 ′ having a C-shaped cross section while heating. The diameter of the metal ring 6 ′ is reduced at the outer periphery of the flexible sheath 1. The flexible sheath 1 is thermoformed into a state of being gradually constricted by being pushed by the metal ring 6 '.

  Next, as shown in FIG. 6, when there is no gap in the C-shaped cut of the metal ring 6 ′, a continuous annular clamping ring 6 is welded by welding the cut by laser welding or the like. Is formed. 8 is a welding part. The constricted part 5 formed in this way maintains its shape over a long period of time without expanding its inner diameter.

  As shown in FIGS. 1 and 2, when an electrically insulating fastening ring covering ring 7 made of a heat-shrinkable tube or the like is covered so as to cover the outer peripheral surface of the fastening ring 6, a high-frequency treatment is performed. In addition, the metal fastening ring 6 does not touch the surrounding biological mucous membrane. The fastening ring covering ring 7 is attached in a state of being hidden from the outer peripheral surface of the flexible sheath 1 so as not to protrude outward from the outer periphery of the flexible sheath 1.

  In addition, the width of the tightening ring covering ring 7 is formed larger than the width of the tightening ring 6 so that the tightening ring covering ring 7 covers the entire tightening ring 6 as shown in FIG. Thus, if the fastening ring covering ring 7 is formed to have the same width as the fastening ring 6, there is an advantage that it can be easily manufactured at low cost. The same applies to each embodiment described later.

  The inner surface rear end wall portion of the constricted portion 5 formed in such a manner is formed into a tapered shape whose inner diameter gradually expands to the rear side, and the stopper receiving portion 9 formed on the connecting member 4 comes into contact with the stopper so as to be able to contact and separate. It is eight. Therefore, when the operation wire 3 advances and retreats in the axial direction in the flexible sheath 1, the stopper receiving portion 9 comes into contact with the stopper 8 provided on the flexible sheath 1 side so as to be able to contact and separate.

  In the endoscope treatment tool configured as described above, the stopper receiving portion 9 is moved to the stopper 8 as shown in FIG. 1 by moving the operation wire 3 forward and backward in the axial direction by an operation from the operation portion 10. 2 and the rotation suppression position where the rotation of the distal treatment member 2 is inhibited by the frictional resistance between the two, and as shown in FIG. The stopper receiving portion 9 can be moved to a suppression release position that is rotatable in the direction around the axis with respect to the flexible sheath 1.

  As shown in FIG. 1, when the stopper receiving portion 9 is in the rotation suppression position, the distal treatment member 2 protrudes from the distal end of the flexible sheath 1 by a predetermined length, and the distal treatment member 2 The tip treatment member 2 does not rotate in the direction around the axis line only by lightly touching the mucosal surface or simply touching the rotation holding ring 15 on the operation unit 10 side.

  As shown in FIG. 2, in the state where the stopper receiving portion 9 is in the suppression release position, the direction of the distal treatment member 2 in the direction around the axis can be arbitrarily adjusted by remote operation from the operation portion 10.

  8 and 9 show the cross-sectional shape of the constricted portion 5 of the second and third embodiments of the present invention, and the illustration of the connecting member 4 is omitted. In the first embodiment described above, the cross-sectional shape of the inner surface of the constricted portion 5 is circular. However, in the second and third embodiments, the cross-sectional shape of the inner surface of the constricted portion 5 is made noncircular and tightened. The cross-sectional shape of the attached wheel 6 is also formed in a non-circular cross-sectional shape corresponding to the inner surface of the constricted portion 5. Thus, the cross-sectional shape of the constricted portion 5 may be any shape.

  In addition, this invention is not limited to said each Example, For example, you may apply this invention to the mechanical treatment tool etc. for which the high frequency current is not supplied with the front-end | tip treatment member 2. FIG.

FIG. 3 is a side cross-sectional view of the distal end portion of the endoscope treatment tool according to the first embodiment of the present invention in a state where the distal treatment member protrudes from the distal end of the flexible sheath. FIG. 3 is a side sectional view of the distal end portion of the endoscope treatment tool according to the first embodiment of the present invention in a state where the distal treatment member is retracted into the distal end of the flexible sheath. BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is an overall configuration diagram of an endoscope treatment tool according to a first embodiment of the present invention. It is a partial exploded perspective view of the treatment tool for endoscopes of the 1st example of the present invention. It is sectional drawing of a cross section perpendicular | vertical to the axis line of the state in the middle of the process in which the clamp ring is attached to the treatment tool for endoscopes of 1st Example of this invention. It is sectional drawing of a cross section perpendicular | vertical to the axis line of the state in which the clamp ring was attached to the treatment tool for endoscopes of 1st Example of this invention. It is side surface sectional drawing of the modification of the constriction part of the treatment tool for endoscopes of 1st Example of this invention. It is a schematic sectional drawing of a cross section perpendicular | vertical to the axis line of the constriction part of the treatment tool for endoscopes of the 2nd Example of this invention. It is a schematic sectional drawing of a cross section perpendicular | vertical to the axis line of the constriction part of the treatment tool for endoscopes of the 3rd Example of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Flexible sheath 2 End treatment member 3 Operation wire (operation member)
4 Connecting member (operation member)
5 Constricted part 6 Clamping ring 7 Clamping ring covering ring 8 Stopper 9 Stopper receiving part 10 Operation part 15 Rotating holding ring

Claims (6)

The distal end of the flexible sheath projects and retracts from the distal end of the flexible sheath by the forward and backward movement of the operational member at the distal end of the operational member that is inserted in the flexible sheath so as to be movable forward and backward in the axial direction and rotatable in the direction around the axial line A distal end treatment member that rotates in the direction around the axis of the flexible sheath is connected by a rotation operation of the operation member, and a stopper receiving portion that comes in contact with and separates from a stopper provided on the flexible sheath side Provided on the operating member,
As the operation member advances and retreats in the axial direction, the stopper receiving portion comes into contact with the stopper and the rotation of the distal treatment member is suppressed, and the stopper receiving portion moves away from the stopper and moves away from the stopper. In an endoscope treatment instrument in which the stopper receiving portion is movably provided at a suppression release position where a distal treatment member is rotatable in a direction around an axis with respect to the flexible sheath.
At least the distal end portion of the flexible sheath is formed of a flexible tube, and a constricted portion protruding inward is formed therein, and the constricted portion is configured to be flexible so that the inner diameter of the constricted portion does not widen. A fastening ring made of a rigid material to be tightened from the outer peripheral side of the tube is fixedly attached to the flexible tube, and an inner surface rear end wall portion of the constricted portion serves as the stopper ,
The flexible tube is formed of an electrically insulating material, and the operation member and the distal treatment member are each formed of a conductive material, and a high frequency is supplied to the distal treatment member via the operation member. It can be energized with current,
From the outer peripheral surface of the flexible tube, a fastening ring covering ring made of an electrically insulating material covers the outer surface of the fastening ring and does not protrude outward from the outer periphery of the flexible tube. Endoscopic treatment instrument characterized by being attached in a dive state .   The endoscopic treatment instrument according to claim 1, wherein a cross-sectional shape of an inner surface of the constricted portion and a cross-sectional shape of the fastening ring are both circular. The fastening ring is formed by reducing the diameter of a metal ring having a C-shaped cross section at the outer peripheral portion of the constricted portion so that there is no gap in the C-shaped cut and welding the cut. The endoscope treatment tool according to claim 2.   The endoscopic treatment tool according to claim 1, wherein a cross-sectional shape of the fastening ring is non-circular, and a cross-sectional shape of an inner surface of the constricted portion is formed in a non-circular shape corresponding to the fastening ring. The endoscope treatment tool according to any one of claims 1 to 4, wherein the fastening ring covering ring is a heat shrinkable tube. The endoscope according to any one of claims 1 to 5, wherein a width of the fastening ring and a fastening ring covering ring in a longitudinal direction of the flexible tube are formed to be the same width. Treatment tool.

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