JP5312868B2 - Endoscopic treatment tool - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a treatment tool for an endoscope which can be opened and closed while retaining sufficient open angle and width at a position near the front end of the endoscope. <P>SOLUTION: A high-frequency treatment tool 1, a treatment tool for an endoscope, includes: a treatment section 2 having a first forceps member 6 and a second forceps member 7 pivotably connected to each other by a rotation shaft 5, an urging member 11 attached so as to open the tips of the first forceps member 6 and the second forceps member 7 at a distance, and an open and close section 17 attached relatively movably in the longitudinal direction of the first forceps member 6 and the second forceps member 7. The open and close section 17 relatively moves back and forth in the open and close directions of the first forceps member 6 and the second forceps member 7, which pushes the first forceps member 6 and the second forceps member 7 against the biasing force of the urging member 11 to bring the tips of the first forceps member 6 and the second forceps member 7 into closer relationship and close them. <P>COPYRIGHT: (C)2010,JPO&amp;INPIT

Description

  The present invention relates to an endoscopic treatment tool that is inserted into a body cavity transendoscopically and performs a procedure on a tissue.

2. Description of the Related Art Conventionally, an endoscopic treatment tool that is inserted into a body cavity by a transendoscope and performs various procedures on tissue in a body cavity of a patient is known.
As a typical endoscopic treatment tool, a forceps described in Patent Document 1 is known. In this forceps, a pin provided on the base end side of a pair of forceps members that are rotatably connected is inserted into a cam groove provided in a forceps opening / closing member. When the forceps opening / closing member advances the operation rod attached to the tip, the forceps member is opened / closed by moving the above-described pin along the cam groove.

Moreover, the forceps described in Patent Document 2 can be given as another example of the endoscope treatment tool. This forceps is configured to open and close the forceps piece when an operation wire connected to the proximal ends of a pair of forceps pieces for performing treatment in the body is advanced and retracted.
JP-A-6-311986 JP 2005-58344 A

  However, although the forceps described in Patent Document 1 can open and close the forceps member without protruding so much from the distal end of the inserted endoscope, the shape of the cam groove is limited. There is a limit. As a result, it is difficult to obtain a sufficient opening width of the forceps member. If the length of the forceps member is increased, a larger opening width can be ensured. However, there is a problem that insertability and operability as a treatment instrument are impaired.

  On the other hand, although the forceps described in Patent Document 2 are better than the forceps described in Patent Document 1 in terms of the opening angle and opening width of the forceps pieces, the forceps pieces are structurally open when the forceps are sufficiently opened. Is far away from the tip of the endoscope. As a result, there are problems such as difficulty in observing the affected area with an endoscope and lowering operability during the procedure.

  The present invention has been made in view of the above circumstances, and provides an endoscope treatment tool that can be opened and closed while securing a sufficient opening angle and opening width at a position close to the distal end of the endoscope. With the goal.

The endoscope treatment tool of the present invention is attached so that a treatment portion having a pair of forceps members connected to each other by a rotation shaft and a distal end side of the pair of forceps members are opened apart from each other. An urging member; an opening / closing portion attached to be movable relative to the longitudinal direction of the pair of forceps members; a first electrical contact provided on at least one outer surface of the pair of forceps members; A second electrical contact provided on a surface facing the pair of forceps members, the second electrical contact is configured to be electrically connectable to a high-frequency power source , The pair of forceps members are moved relative to each other so as to overlap each other, thereby pressing the pair of forceps members against the urging force of the urging member and approaching the distal ends of the pair of forceps members is not can be closed, the said When the closing portion relatively moves in the longitudinal direction of the pair of forceps members and the first electric contact and the second electric contact come into contact with each other, the forceps provided with the first electric contact from the high-frequency power source A high-frequency current is supplied to the member .

According to the endoscope treatment tool of the present invention, the biasing member can be opened and closed, the opening angle of the pair of forceps members is kept large, and a large opening width is obtained even when the forceps members are short. Secured. Then, by relatively moving the opening / closing part so as to overlap the forceps member, the treatment part can be easily opened / closed without causing the treatment part to protrude so much.
Furthermore, in this case, a high-frequency current can be applied only when the pair of forceps members of the treatment tool is closed, and the procedure can be performed efficiently.

  The endoscope treatment tool of the present invention includes a first coil sheath in which the treatment portion is provided at the distal end, a second coil sheath in which the first sheath is inserted, and the opening and closing portion is provided in the distal end side. May be further provided. If it does in this way, when opening a treatment part, the 1st coil sheath will be compressed and tensile tension will act on the 2nd coil sheath. Further, when the treatment portion is closed, tensile tension acts on the first coil sheath, and the second coil sheath is compressed. Therefore, flexibility can be ensured while enhancing resistance to compression and tensile tension.

  According to the endoscope treatment tool of the present invention, the opening / closing operation can be performed at a position close to the distal end of the endoscope while ensuring a sufficient opening angle and opening width.

  Hereinafter, an endoscope treatment tool according to a first embodiment of the present invention will be described with reference to FIGS. 1 to 5. A high-frequency treatment instrument 1 which is an example of an endoscopic treatment instrument of the present embodiment is used by being supplied with a high-frequency current from a power source (not shown). As shown in FIG. The treatment part 2 for performing a treatment, the operation part 3 for operating the treatment part 2, and the insertion part 4 for connecting the treatment part 2 and the operation part 3 are provided.

  FIG. 2 is an enlarged view showing the distal end side of the high-frequency treatment instrument 1 in a partial cross section. As shown in FIG. 2, the treatment section 2 includes a pair of forceps members including a first forceps member 6 and a second forceps member 7 that are rotatably connected to each other by a rotation shaft 5.

  The first forceps member 6 located on the upper side in FIG. 2 is made of a ceramic member such as alumina or zirconia, or a resin such as polytetrafluoroethylene (PTFE) or PEEK (registered trademark), and has an insulating property. Yes. In addition, it may replace with such a structure and may be comprised with metals, such as stainless steel, and the insulating coating was made | formed on the surface.

On the other hand, the lower second forceps member 7 is formed of a conductive material such as stainless steel, and an electrode portion 8 for energizing the tissue in the body cavity at the distal end region facing the first forceps member 6 during treatment. Function. The first forceps member 6 is connected to a power supply wire 10 via a connection member 9.
Note that the second forceps member 7 may be subjected to an insulation process on portions other than the electrode portion 8. In the insulation process, an insulation coating may be used, or an insulating member may be attached by adhesion or the like.

  As shown in FIGS. 2 and 3, a biasing member 11 is attached to the first forceps member 6 and the second forceps member 7, and the forceps members 6 and 7 rotate around the rotation shaft 5. However, it is always urged to open so that the tip side is spaced apart. The opening angle of the forceps members 6 and 7 by the urging member 11 is preferably set to a large angle of, for example, 60 degrees or more in order to perform the procedure appropriately. As the urging member 11, a member having elasticity such as various springs made of a rod-like or plate-like member as shown in FIG. 3 can be suitably used.

As shown in FIG. 2, the insertion portion 4 includes a first coil sheath (first coil sheath) 12 having a treatment portion 2 attached to the tip, and a cladding tube portion through which the first coil sheath 12 is inserted so as to be able to advance and retract in the axial direction. 13.
The first coil sheath 12 has a known configuration in which a strand of metal or the like is tightly wound, and the wire 10 is inserted therein. The treatment section 2 is attached to the distal end of the first coil sheath 12 through a connecting member 14 so as not to advance or retreat. As a result, the treatment section 2 is advanced and retracted integrally with the first coil sheath 12.

  The cladding tube portion 13 includes a second coil sheath (second coil sheath) 15 through which the first coil sheath is inserted, an insulation tube 16 that insulates the outer surface of the second coil sheath 15, and tips of the second coil sheath 15 and the insulation tube 16. And an opening / closing part 17 attached to the side. The basic portion of the covering tube portion 13 composed of the second coil sheath 15 and the insulating tube 16 has substantially the same configuration as that of the flexible tube in the conventional treatment instrument for endoscope that is covered with insulation.

  The opening / closing part 17 is a substantially cylindrical member and is integrally attached to the insulating tube 16 via a connection pipe 18. The opening / closing part 17 is formed of a material having such a rigidity that the forceps members 6 and 7 can be closed against the urging force of the urging member 11 in the opening / closing operation of the treatment part 2 described later.

  Returning to FIG. 1, the operation unit 3 includes an elongated operation unit main body 18 and a slider 19 attached to the operation unit main body 18 so as to be relatively movable in the axial direction. The operation portion main body 18 is provided with an insertion portion hole 18A through which the insertion portion 4 is inserted, and the cladding tube portion 13 is inserted through the insertion portion hole 18A and the base end thereof is connected. The proximal ends of the first coil sheath 12 and the wire 10 inserted through the insertion portion 4 are connected to the slider 19. A finger-handle 20 is provided at the proximal end of the operation unit body 18.

  A plug 21 to which a power cable (not shown) connected to a high frequency power source (not shown) is connected is attached to the slider 19 and is electrically connected to the wire 10. Therefore, when a high frequency power source is connected to the plug 21 via the power cable and energized, the high frequency current is supplied to the second forceps member 7 having the electrode portion 8 through the wire 10 and the connection member 9.

Operation during use of the high-frequency treatment instrument 1 configured as described above will be described.
First, an endoscope (not shown) is inserted into the body of a patient in contact with a known counter electrode plate (not shown), and the distal end of the endoscope is advanced to the vicinity of the tissue in the body cavity to be treated.

  Subsequently, the slider 19 is moved backward with respect to the operation portion main body 18 to close the pair of forceps members 6 and 7 (this operation will be described later), and the treatment portion 2 and the insertion into the forceps channel (not shown) of the endoscope. Insert part 4. And after making the treatment part 2 protrude from a forceps channel, the high frequency power supply and the plug 21 are connected with a power cable.

  When performing the treatment, the slider 19 is moved forward with respect to the operation unit main body 18. Then, the first coil sheath 12 and the wire 10 connected to the slider 19 advance with respect to the cladding tube portion 13. In conjunction with this, the treatment portion 2 also moves relative to the cladding tube portion 13 so as to advance, and protrudes from the tip of the opening / closing portion 17. When the forceps members 6 and 7 of the treatment part 2 are completely exposed from the opening / closing part 17, the urging member 11 is rotated so that the distal end sides of the forceps members 6 and 7 are separated from each other. As shown in FIG. open.

  When the user places the target tissue between the open forceps members 6 and 7 of the treatment section 2 and pulls the slider 19 back to the proximal end side of the operation section main body 18, the first coil sheath 12 and the wire 10 are moved to the covering tube section 13. The treatment part 2 moves toward the opening / closing part 17 in conjunction with this. When the slider 19 is further pulled back after the tip of the opening / closing part 17 and the pair of forceps members 6, 7 contact each other, the opening / closing part 17 overlaps the forceps members 6, 7 in the opening / closing direction of the forceps members 6, 7. That is, the positions of the forceps members 6 and 7 and the opening / closing part 17 are substantially the same in the longitudinal direction of the insertion part 4. Then, as shown in FIG. 5, the forceps members 6 and 7 are rotated against the biasing force of the biasing member 11 by the opening / closing part 17 so as to be closed. In this way, the target tissue is sandwiched between the treatment sections 2. And the electrode part 8 contacts the body tissue which is a treatment object.

In this state, when the user supplies a high-frequency current from the high-frequency power source, the high-frequency current is supplied to the electrode unit 8 through the above-described path, and the target tissue is cauterized by the high-frequency current.
When the user further retracts the slider 19 after the treatment is completed, the forceps members 6 and 7 are completely closed and accommodated in the insertion portion 4. After the distal end of the high-frequency treatment instrument 1 is in such a state, the user removes the high-frequency treatment instrument 1 from the forceps channel and removes the endoscope from the body to finish the procedure.

  According to the high-frequency treatment instrument 1 of the present embodiment, when the treatment portion 2 is moved to the distal end side with respect to the opening / closing portion 17 by the operation of the slider 19 and exposed, the pair of first forces are applied by the biasing force of the biasing member 11. The forceps member 6 and the second forceps member 7 are rotated about the rotation shaft 5, and the distal ends of the forceps members 6 and 7 are immediately opened at a large opening angle. Therefore, it is possible to provide an endoscope treatment tool that can open and close the treatment portion near the distal end of the endoscope to be inserted and at a large opening angle.

  Further, since the insertion portion 4 includes two coil sheaths, the first coil sheath 12 and the second coil sheath 15, when the pair of forceps members 6 and 7 of the treatment portion 2 are opened, the first coil sheath is compressed, Tensile tension acts on the two-coil sheath. Further, when the forceps members 6 and 7 are closed, tensile tension acts on the first coil sheath, and the second coil sheath is compressed. Therefore, flexibility can be ensured while enhancing resistance to compression and tensile tension.

  In the present embodiment, an example of a so-called monopolar type high-frequency treatment instrument in which a high-frequency current is supplied to only one second forceps member 7 out of a pair of forceps members has been described. The high-frequency treatment device of the present invention may be configured as a so-called bipolar high-frequency treatment device in which treatment electrodes are provided on both forceps members. In this case, the first forceps member 6 may be configured similarly to the second forceps member 7.

  Further, the endoscope treatment tool of the present invention may be configured as a simple grasping forceps that does not include the wire 10 or the plug 21 and does not energize the treatment portion. Even if it does in this way, the effect regarding the opening-and-closing behavior of the treatment part mentioned above can be acquired similarly.

Next, a second embodiment of the present invention will be described with reference to FIGS. The difference between the high-frequency treatment instrument 31 of the present embodiment and the above-described high-frequency treatment instrument 1 is the connection mode between the second forceps member and the plug.
In addition, about the structure which is common in the above-mentioned high frequency treatment tool 1, the same code | symbol is attached | subjected and the overlapping description is abbreviate | omitted.

FIG. 6 is a view showing a tip of the high-frequency treatment instrument 31 in a partial cross section. As shown in FIG. 6, the high-frequency treatment instrument 31 is not provided with the wire 10, and instead, an electrical contact (second electrical contact) 32 is provided on the inner surface near the distal end of the opening / closing part 17. . A power supply cord 33 is connected to the electrical contact 32, and the power supply cord 33 passes between the first coil sheath 12 and the second coil sheath 15 and is connected to the plug 21 (not shown).
Further, in the high-frequency treatment instrument 31, the plug 21 is attached not to the slider 19 but to the operation unit main body 18. Therefore, the power supply cord 33 and the plug 21 are not slidable with respect to the operation unit main body 18.

The operation at the time of use of the high-frequency treatment instrument 31 configured as described above will be described below.
The point that the treatment section 2 opens when the slider 19 is moved forward with respect to the operation section main body 18 is the same as the high-frequency treatment instrument 1 of the first embodiment.
When the slider 19 is retracted with respect to the operation unit main body 18 to close the treatment unit 2, the opening / closing unit 17 and the forceps members 6 and 7 of the treatment unit 2 come into contact with each other. Then, as the forceps members 6 and 7 are closed, first, a part (first electrical contact) of the second forceps member 7 and the electrical contact 32 come into contact with each other and become conductive.
As shown in FIG. 7, when the treatment portion 2 is further drawn into the insertion portion 4, the forceps members 6 and 7 are completely closed.

According to the high-frequency treatment tool 31 of the present embodiment, when the treatment unit 2 is open and not in contact with the electrical contact 32, no high-frequency current is supplied to the treatment unit 2, so that the treatment unit 2 is not a treatment target in a body cavity. It is possible to suitably prevent current from leaking in contact with tissue or the like.
On the other hand, since the high-frequency current is supplied to the electrode unit 8 when the forceps members 6 and 7 are closed and the desired opening angle is set in advance, for example, when the tissue is grasped, the high-frequency current is reliably applied to the electrode unit 8 It is also possible to adjust so that a current is supplied and an energization treatment is performed. Therefore, it is possible to perform the treatment efficiently by reliably supplying the high-frequency current only when necessary to the treatment section 2.

In addition, since the power supply cord 33 does not advance or retreat in accordance with the opening / closing operation of the treatment section 2, the force associated with the advancement / retraction does not act. Can be configured. Therefore, even if the power supply cord 33 is wired between the first coil sheath 12 and the second coil sheath 15, it does not prevent the first coil sheath 12 from sliding in the cladding tube portion 13 and maintains good operability. be able to.
The power supply cord 33 may be connected to the slider 19 through the first coil sheath 12.

In the present embodiment, as in the modification shown in FIG. 8, a part of the outer surface of the second forceps member 7 may be covered with an insulating portion 34. The insulating part 34 can be formed by attaching a partially insulating member or applying an insulating coating.
If it does in this way, it will become possible to supply a high frequency current to the electrode part 8 only when the forceps members 6 and 7 are closed or opened depending on the position of the insulating part 34. The opening angle of the forceps members 6 and 7 when the high-frequency current is supplied to the electrode unit 8 can be adjusted as appropriate by changing the position and shape of the insulating unit 34.
In this case, the outer surface of the second forceps member 7 on the distal end side with respect to the insulating portion 34 functions as a first electrical contact for contacting the electrical contact 34 and supplying a high-frequency current to the electrode portion 8.

  As yet another example, the outer surface of the proximal end side of the second forceps member 7 may be entirely covered with insulation, and a part of the conductive outer surface may be exposed, and the outer surface may be used as the first electrical contact.

Next, a third embodiment of the present invention will be described with reference to FIGS. The difference between the high-frequency treatment instrument 41 of the present embodiment and the above-described high-frequency treatment instrument 1 is the shape of the opening / closing part.
In addition, about the structure which is common in each above-mentioned embodiment, the same code | symbol is attached | subjected and the overlapping description is abbreviate | omitted.

FIG. 9 is a side view of the distal end side of the high-frequency treatment instrument 41, and FIG. 10 is a perspective view showing an operation during use of the distal end side.
As shown in FIGS. 9 and 10, the opening / closing part 42 is provided with an opening / closing wall 43 for closing the treatment part 2 on the distal end side so as to protrude in the axial direction.

  Two opening / closing wall surfaces 43 are provided at both ends in the opening / closing direction of the forceps members 6 and 7 so as to be substantially orthogonal to the opening / closing surface F of the forceps members 6 and 7. The electrical contact 32 is provided on the inner surface of the open / close wall surface 43 </ b> A that contacts the second forceps member 7.

  In the high-frequency treatment instrument 41 of the present embodiment, as shown in FIG. 10, the two openable / closable wall surfaces 43 are pressed by contacting the first forceps member 6 and the second forceps member 7, respectively, so that the treatment section 2 is pressed. close up. Then, when the outer surface of the second forceps member 7 and the electrical contact 32 come into contact with each other, a high frequency current is supplied to the electrode portion 8.

  Since the open / close wall surface 43 is formed only in the vertical direction shown in FIG. 10, even if the slider 19 is further retracted by a certain length from the state shown in FIG. 42 is not covered. Therefore, the opening / closing part 42 does not get in the way when the treatment part 2 grasps the tissue, and the treatment part 2 is closed while more appropriately grasping the tissue by fully using the distal end side regions of the forceps members 6 and 7. Treatment can be performed.

  Although the embodiments of the present invention have been described above, the technical scope of the present invention is not limited to the above embodiments, and various modifications can be made without departing from the spirit of the present invention.

  For example, in each of the above-described embodiments, an example has been described in which the insertion portion includes the first coil sheath connected to the treatment portion and the cladding tube portion through which the first coil sheath is inserted. A wire connected to the proximal ends of the pair of forceps members is inserted through a sheath made of a coil or the like, and an opening / closing portion having a cylindrical shape or an opening / closing wall structure as described above is provided on the distal end side of the sheath. An endoscopic treatment tool may be configured. In this case as well, it is possible to close the treatment portion by retracting the wire, moving the treatment portion relative to the sheath, and overlapping the opening / closing portion and the pair of forceps members in substantially the same manner as described above.

1 is an overall view of a high-frequency treatment tool that is a treatment tool for an endoscope according to a first embodiment of the present invention. It is a side view which shows the front end side of the same high frequency treatment tool in a partial cross section. It is a figure which shows the treatment part of the high frequency treatment tool. It is a figure which shows the operation | movement at the time of use of the high frequency treatment tool. It is a figure which shows the operation | movement at the time of use of the high frequency treatment tool. It is a figure which shows the front end side of the high frequency treatment tool of 2nd Embodiment of this invention in a partial cross section. It is a figure which shows the operation | movement at the time of use of the high frequency treatment tool. It is a figure which shows the front end side of the high frequency treatment tool of the modification of the embodiment in a partial cross section. It is a side view which shows the front end side of the high frequency treatment tool of 3rd Embodiment of this invention in a partial cross section. It is a figure which shows the operation | movement at the time of use of the front end side.

Explanation of symbols

1, 31, 41 High-frequency treatment tool (endoscopic treatment tool)
2 treatment section 5 rotating shaft 6 first forceps member 7 second forceps member 10 wire 11 biasing member 12 first coil sheath (first coil sheath)
15 Second coil sheath (second coil sheath)
17, 42 Opening / closing part 32 Electrical contact (second electrical contact)

Claims (2)

A treatment portion having a pair of forceps members coupled to each other by a pivot shaft;
An urging member attached so that the distal ends of the pair of forceps members are spaced apart; and
An opening / closing part attached to the longitudinal direction of the pair of forceps members so as to be relatively movable;
A first electrical contact provided on at least one outer surface of the pair of forceps members;
A second electrical contact provided on a surface of the opening / closing portion facing the pair of forceps members;
With
The second electrical contact is configured to be electrically connectable to a high frequency power source,
The opening / closing portion moves relative to each other so as to overlap in the opening / closing direction of the pair of forceps members, thereby pressing the pair of forceps members against the biasing force of the biasing members, The tip side can be approached and closed ,
When the opening / closing part relatively moves in the longitudinal direction of the pair of forceps members and the first electrical contact and the second electrical contact come into contact with each other, the first electrical contact is provided from the high-frequency power source. A treatment instrument for an endoscope , wherein a high-frequency current is supplied to a forceps member . A first coil sheath provided at the distal end with the treatment portion;
A second coil sheath in which the first sheath is inserted and the opening / closing portion is provided on a distal end side;
The endoscopic treatment tool according to claim 1, further comprising:

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