JP5355054B2 - Endoscopic treatment tool - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a treatment instrument for endoscopes which makes rotation control act on an arbitrary region of a protruding and retreating range of a distal end treatment member protruding and retreating from the distal end of a flexible sheath and shows excellent durability for sustaining the feature after the repeated use. <P>SOLUTION: A cylindrical distal end cap 4 is mounted on the distal end of the flexible sheath 1. A slidable contact peripheral surface 5 which makes slidable contact with the inner circumferential side of the distal end cap 4 is provided in the vicinity of a joint between an operational wire 3 and the distal end treatment member 2. A slidable contact part 6 which makes slidable contact with the surface 5 and generates a frictional resistance relative to rotational movements in the direction around the axis when the distal end treatment member 2 is in a prescribed region of a range to move in the axial direction relative to the distal end cap 4 is formed on the inner circumferential part of the distal end cap 4. <P>COPYRIGHT: (C)2010,JPO&amp;INPIT

Description

  The present invention relates to an endoscope treatment tool.

  As an endoscope treatment tool, the distal end of a flexible sheath is projected and retracted from the distal end of an operation wire 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 in contact with and separates from the operation wire side, and the operation wire side advance and retreat operation and the rotation restriction of the distal treatment member are linked (for example, Patent Document 1).

Further, by adopting a configuration in which the cross-sectional shape in the vicinity of the distal end of the flexible tube forming the flexible sheath is made non-circular, resistance is imparted to the rotational operation of the distal treatment member, and the distal treatment member is attached to the flexible sheath. Some of them are restricted so as not to rotate freely (for example, Patent Documents 2 and 3).
JP2004-261372 JP2007-215786A JP-A-2005-270240

  In the invention described in Patent Document 1, with the advancement / retraction operation of the operation wire in the axial direction, the stopper receiving portion abuts against the stopper to suppress the rotation of the distal treatment member, 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.

  However, in such a configuration, since the rotation of the distal treatment member is restricted only when the distal treatment member protrudes most from the distal end of the flexible sheath and comes into contact with the stopper, the projection length of the distal treatment member is appropriately adjusted. I can't use it like doing treatment.

  In the inventions described in Patent Documents 2 and 3, etc., the flexible tube forming the flexible sheath has a low shape retaining property. Therefore, when an external force is applied or repeated use, a non-circular cross-sectional shape is obtained. Gradually returns to a circle. Then, the distal treatment member can always freely rotate at the distal end of the flexible sheath, and the distal treatment member cannot be held in a desired direction.

  According to the present invention, the distal treatment member that projects from the distal end of the flexible sheath can be subjected to rotation regulation in an arbitrary region of the projecting and retracting range, and the durability is maintained even if the use is repeated. It is an object of the present invention to provide an excellent endoscopic treatment tool.

In order to achieve the above object, an endoscope treatment instrument according to the present invention has an operation wire inserted and disposed in a flexible sheath so as to be movable forward and backward in the axial direction and rotatable in a direction around the axis. A treatment instrument for an endoscope, in which a distal treatment member that protrudes and retracts from the distal end of the flexible sheath by an advance / retreat operation and rotates around the axis of the flexible sheath by a rotational operation of the operation wire is connected to the distal end of the operation wire A substantially cylindrical tip cap is attached to the tip of the flexible sheath, and a rear end side portion in the axial direction of the tip cap is coaxially inserted into the flexible sheath, and a rear end side of the tip cap An outer peripheral surface for sliding contact that is in sliding contact with the inner peripheral side of the portion is provided in the vicinity of the connecting portion between the operation wire and the distal treatment member, and the distal treatment member is disposed on the distal end cap on the inner peripheral portion of the rear end side portion of the distal end cap. On the other hand, in a predetermined area that can move in the axial direction The Rutoki, have sliding contact portion to cause the frictional resistance to rotational movement about the axis line direction is formed in contact with sliding contact the outer peripheral surface in sliding, the rear end portion of the tip cap, radially to the tip cap The slit for imparting elasticity is formed in a position parallel to the axis at a position where it does not interfere with the sliding contact portion, and the outer peripheral surface of the rear end side portion of the tip cap is the inner peripheral surface of the flexible sheath Is formed with a smaller diameter than the inner peripheral surface of the flexible sheath so that a gap is formed between the inner and outer surfaces of the flexible sheath .

  When the distal treatment member is at the most advanced position within the range movable in the axial direction with respect to the distal end cap, the outer peripheral surface for sliding contact and the sliding contact portion are in sliding contact, and when in the rear end position, sliding contact is made. The outer peripheral surface for sliding and the sliding contact portion may not slide.

  Also, when the distal treatment member is at the most advanced position within the range movable in the axial direction with respect to the distal end cap and at the rear end position, the sliding contact outer peripheral surface and the sliding contact portion should not be in sliding contact. Alternatively, when the distal treatment member is at the most distal position within the range movable in the axial direction with respect to the distal end cap, the outer peripheral surface for sliding contact and the sliding contact portion are not slidably contacted to the rear end position. In some cases, the sliding contact outer peripheral surface and the sliding contact portion may be in sliding contact.

  Further, the sliding contact portion may be formed inwardly projecting from a part of the inner periphery of the tip cap, and the sliding contact portion may be formed elongated in a direction parallel to the axis of the tip cap. A plurality of sliding contact portions may be provided at different positions in the circumferential direction of the tip cap.

Also, a flange is formed at the distal end of the distal end cap, and the portion between the flange and the rear end portion in the axial direction of the distal end cap is used for fixing with a larger diameter than the outer peripheral surface of the rear end portion. the outer peripheral surface is formed, the flange portion is fixed to the front end face of the flexible sheath, the fixed outer peripheral surface but it may also have been fixed to the inner circumferential surface of the flexible sheath. In addition , the operation wire may be formed of a stranded wire, and the outer peripheral surface for sliding contact may be formed by attaching a sticking agent to the outer peripheral portion near the tip of the operation wire and finishing the outer peripheral surface into a smooth surface. . Moreover, the outer peripheral surface for sliding contact may be formed by the surface of the cylindrical body attached to the outer periphery of the front-end | tip part of an operation wire.

  According to the present invention, the outer peripheral surface for sliding contact that is in sliding contact with the inner peripheral side of the substantially cylindrical distal end cap attached to the distal end of the flexible sheath is provided in the vicinity of the connecting portion between the operation wire and the distal treatment member. A sliding contact portion that slidably contacts with the sliding contact outer peripheral surface when the distal treatment member is in a predetermined region within a range movable in the axial direction with respect to the distal end cap, and generates a frictional resistance with respect to rotational movement in the direction around the axis. By being formed on the inner periphery of the tip, the tip treatment member protruding from the distal end of the flexible sheath can be subjected to rotation regulation in any region of the protruding and retracting range, and it can be used. Even if it repeats, the outstanding durability which the function lasts can be acquired.

  An operation wire is inserted and arranged 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, and protrudes and retracts from the distal end of the flexible sheath by the forward and backward movement of the operational wire and rotates the operation wire. In the endoscope treatment tool in which the distal treatment member rotating in the direction around the axis of the flexible sheath is connected to the distal end of the operation wire, a substantially cylindrical distal end cap is attached to the distal end of the flexible sheath. An outer peripheral surface for sliding contact that is in sliding contact with the inner peripheral side of the distal end cap is provided in the vicinity of the connecting portion between the operation wire and the distal end treatment member. A sliding contact portion is formed that is in sliding contact with the outer peripheral surface for sliding contact and generates frictional resistance against rotational movement in the axial direction when in a predetermined region within a range movable in the axial direction.

Embodiments of the present invention will be described below with reference to the drawings.
FIG. 10 shows the overall configuration of the endoscope treatment tool according to each 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.

  Reference numeral 2 denotes a distal treatment member that projects from the distal end of the flexible sheath 1, and is, for example, a conductive high-frequency electrode formed in a hook shape that is used for incision of a mucous membrane when a high-frequency current is applied. However, the distal treatment member 2 may have other shapes or the like.

  In the flexible sheath 1, a conductive operation wire 3 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 treatment member 2 is connected.

  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. Reference numeral 4 denotes a tip cap attached to the tip 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 protrudes and retracts from the distal end (that is, the distal end cap 4). The maximum protrusion length of the distal treatment member 2 from the distal end cap 4 is regulated by the slide range of the slide operation member 12 in the operation unit 10.

  Further, 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 passed through 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.

  FIG. 1 shows a distal end portion of the treatment instrument for an endoscope in a state where the distal treatment member 2 is drawn into the distal end of the flexible sheath 1. The tip cap 4 is made of an electrically insulating plastic material such as polycarbonate resin or polyetheretherketone resin (PEEK), for example, and is formed in a substantially cylindrical shape having a flange 4a at the tip, and is a portion other than the flange 4a. Is inserted straight into the distal end of the flexible sheath 1, and the distal end portion of the flexible sheath 1 and the axis are aligned.

  The fixing outer peripheral surface 4b of the distal end cap 4 located in the distal end of the flexible sheath 1 adjacent to the flange portion 4a and the flange portion 4a are firmly fixed to the flexible sheath 1. Therefore, the distal end cap 4 is fixed to the most distal end portion of the flexible sheath 1 so that it cannot move in the axial direction or in the axial direction.

  The distal treatment member 2 is formed narrower than the operation wire 3 by extending the core wire portion of the operation wire 3 formed of a stranded wire. However, a configuration in which the distal treatment member 2 provided independently of the operation wire 3 is connected to the distal end of the operation wire 3 may be used.

  In the most distal portion of the operation wire 3 (that is, in the vicinity of the connecting portion between the distal treatment member 2 and the operation wire 3), a fixing agent such as silver solder is cooled on the outer periphery of the operation wire 3 after heating. Thus, the outer peripheral surface 5 is smoothly finished to form a sliding contact outer peripheral surface 5 that is in sliding contact with the inner peripheral side of the tip cap 4.

  When the distal treatment member 2 is located in a predetermined region within a range in which the distal treatment member 2 can move in the axial direction relative to the distal end cap 4, the inner peripheral portion of the distal end cap 4 slides on the outer peripheral surface 5 for sliding contact with the distal end of the operation wire 3. A plurality of slidable contact portions 6 for generating frictional resistance against the rotational movement in the direction around the axis of the slidable contact outer peripheral surface 5 (and the distal treatment member 2) are inward from a part of the inner periphery of the distal end cap 4. Is formed to protrude.

  As shown in FIG. 2 illustrating the II-II cross section and FIG. 3, which is a perspective view of the tip end cap 4 alone, the sliding contact portion 6 of this embodiment is formed to be elongated in a direction parallel to the axis of the tip cap 4. Four protrusions are provided on the inner periphery of the tip cap 4 so as to be shifted by 90 ° in the circumferential direction, and each surface is smoothly rounded.

  Returning to FIG. 1, there is a slight gap between the outer peripheral surface of the tip cap 4 and the inner peripheral surface of the flexible sheath 1 at a position behind the fixing outer peripheral surface 4b (upward position in the figure). In order to generate, it is formed in a slightly smaller diameter than the part of the outer peripheral surface 4b for fixation.

  And the sliding contact part 6 is provided in the inner peripheral part of the part, and as FIG.2 and FIG.3 also shows, the some slit 7 for providing radial elasticity to the front-end | tip base 4 is provided. In the direction parallel to the axis, it is formed at a position where it does not interfere with the sliding contact portion 6. In this embodiment, the two slits 7 are formed at 180 ° symmetrical positions, but other modes may be used.

  In the endoscope treatment tool configured as described above, when the distal treatment member 2 is at the rear end position within the range movable in the axial direction with respect to the distal end cap 4 as shown in FIG. As shown in FIG. 4, the sliding contact outer peripheral surface 5 on the operation wire 3 side is not positioned inside the sliding contact portion 6 on the distal end cap 4 side, and the distal treatment member 2 narrower than the sliding contact outer peripheral surface 5 is positioned. doing.

  Therefore, since the sliding contact portion 6 on the distal end cap 4 side and the outer peripheral surface 5 for sliding contact on the operation wire 3 side do not slide, frictional resistance is not applied to the rotational movement of the distal treatment member 2, and the operation wire 3. Is rotated in the direction around the axis from the operation unit 10 side, the distal treatment member 2 rotates smoothly in the direction around the axis, and the direction of the distal end of the distal treatment member 2 formed in a hook shape follows it. Change.

  Then, as shown in FIG. 4, when the operation wire 3 is pushed in from the operation unit 10 side, the distal treatment member 2 is in a predetermined region in the middle of the range movable in the axial direction with respect to the distal end cap 4. When the distal treatment member 2 is at the most distal position within the range movable in the axial direction with respect to the distal end cap 4, the distal treatment member 2 moves toward the distal end side as shown in FIG. The outer peripheral surface 5 for sliding contact on the operation wire 3 side is in sliding contact with the sliding contact portion 6 on the tip end cap 4 side.

  As a result, each of the divided pieces of the distal end cap 4 divided by the slit 7 is elastically deformed in the direction of spreading in the flexible sheath 1, and the sliding contact outer peripheral surface 5 and the sliding contact portion 6 come into contact with each other. Friction resistance is applied to the rotational movement of the distal treatment member 2 at the portion.

  Therefore, even if a force is applied to rotate the distal treatment member 2 in the direction around the axis, the distal treatment member 2 does not rotate, and the distal treatment member 2 is fixed in a desired direction to perform a stable treatment. In addition, since wear deformation or the like hardly occurs in the sliding contact portion 6, excellent durability can be obtained.

  The sliding contact portion 6 on the distal end cap 4 side may have any shape as long as it slides on the sliding contact outer peripheral surface 5 on the operation wire 3 side and generates frictional resistance against rotational motion. For example, as in the second embodiment shown in FIG. 6, it may be the inner peripheral surface of two wide convex portions that sandwich the sliding outer peripheral surface 5 from a position facing 180 °.

  Further, the maximum protruding length of the distal treatment member 2 from the distal end of the distal end cap 4, the axial range in which the sliding contact portion 6 is formed on the distal end cap 4, and the like can be selected as appropriate. For example, as in the third embodiment shown in FIGS. 7 and 8, when the distal treatment member 2 is at the rear end position within the range in which it can move in the axial direction relative to the distal end cap 4, and at the most distal position. In this case, the sliding contact outer peripheral surface 5 on the operation wire 3 side and the sliding contact portion 6 on the distal end cap 4 side do not slide, and the distal treatment member 2 smoothly moves in the direction around the axis with respect to the flexible sheath 1. You may make it rotate. FIG. 9 shows a state in which the distal treatment member 2 is restricted in rotation in the middle of the movable range.

  Further, when the distal treatment member 2 is at the most distal position within the range movable in the axial direction relative to the distal end cap 4, the outer peripheral surface 5 for sliding contact on the operation wire 3 side and the sliding contact portion 6 on the distal end cap 4 side Instead of being in sliding contact, it may be configured to be in sliding contact when in the rear end position.

  As described above, in the present invention, rotation restriction can be applied to the distal treatment member 2 projecting and retracting from the distal end of the flexible sheath 1 in any region of the projecting and retracting range. Excellent durability that maintains its function is obtained.

  In the third embodiment, the outer peripheral surface 5 for sliding contact is formed by the surface of a cylindrical body made of, for example, stainless steel attached to the outer periphery of the distal end portion of the operation wire 3, and there is a margin in diameter. However, it may be configured in this way.

  Further, the present invention may be applied to a mechanical endoscope treatment instrument that is not energized with a high-frequency current.

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 II-II sectional drawing in FIG. 1 of the treatment tool for endoscopes of the 1st Example of this invention. It is a perspective view of the simple substance of the tip mouthpiece of the treatment tool for endoscopes of the 1st example of the present invention. In the endoscope treatment tool according to the first embodiment of the present invention, it is a side cross-sectional view of a distal end portion in a state in which a distal treatment member protrudes. It is VV sectional drawing in FIG. 4 of the treatment tool for endoscopes of 1st Example of this invention. It is sectional drawing (sectional drawing corresponded to VV sectional drawing of a 1st Example) of the treatment tool for endoscopes of the 2nd Example of this invention. It is side surface sectional drawing of the front-end | tip part of the treatment tool for endoscopes of the 3rd Example of this invention. FIG. 9 is a side cross-sectional view of a distal end portion in a state where a distal treatment member protrudes to the maximum extent in an endoscope treatment tool according to a third embodiment of the present invention. It is side surface sectional drawing of the state in which rotation control is acting on the front-end | tip treatment member in the treatment tool for endoscopes of the 3rd Example of this invention. 1 is an overall configuration diagram of an endoscopic treatment tool according to each embodiment of the present invention. FIG.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Flexible sheath 2 Tip treatment member 3 Operation wire 4 Tip cap 5 Outer peripheral surface for sliding contact 6 Sliding contact portion 10 Operating portion

Claims (10)

An operation wire 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, and protrudes and retracts from the distal end of the flexible sheath by the forward and backward movement of the operational wire. In a treatment instrument for an endoscope in which a distal treatment member that rotates in the direction around the axis of the flexible sheath by a rotational motion of the endoscope is connected to the distal end of the operation wire,
A substantially cylindrical tip cap is attached to the tip of the flexible sheath,
The rear end side portion in the axial direction of the tip cap is inserted coaxially into the flexible sheath,
The inner peripheral side sliding contact sliding outer peripheral surface of the rear end portion of the tip cap is provided in the vicinity of connecting portion between the operation wire and the distal end treatment member,
The inner peripheral portion of the rear end side portion of the distal end cap is in sliding contact with the outer peripheral surface for sliding contact when the distal end treatment member is in a predetermined area within a range movable in the axial direction relative to the distal end cap. A sliding contact portion is formed that generates frictional resistance against rotational movement around the axis ,
In the rear end side portion of the tip cap, a slit for imparting radial elasticity to the tip cap is formed at a position that does not interfere with the sliding contact portion, in a direction parallel to the axis,
The outer peripheral surface of the rear end side portion of the tip cap is formed to have a smaller diameter than the inner peripheral surface of the flexible sheath so that a gap is formed between the outer peripheral surface and the inner peripheral surface of the flexible sheath . An endoscopic treatment tool characterized by the above.   The endoscope treatment tool according to claim 1, wherein the sliding contact portion is formed so as to protrude inward from a part of an inner periphery of the distal end cap.   The endoscope treatment tool according to claim 2, wherein the sliding contact portion is formed to be elongated in a direction parallel to the axis of the distal end cap.   The endoscope treatment tool according to claim 3, wherein a plurality of the sliding contact portions are provided at different positions in the circumferential direction of the distal end cap. A flange is formed at the tip of the tip cap,
An outer peripheral surface for fixation having a larger diameter than the outer peripheral surface of the rear end side portion is formed in a portion between the flange portion and the rear end side portion in the axial direction of the tip cap.
5. The inner surface according to claim 1, wherein the flange portion is fixed to a distal end surface of the flexible sheath, and the outer peripheral surface for fixing is fixed to an inner peripheral surface of the flexible sheath . Endoscopic treatment tool.   When the distal treatment member is at the most advanced position within the range movable in the axial direction with respect to the distal end cap, the outer peripheral surface for sliding contact and the sliding contact portion are in sliding contact and at the rear end position The treatment instrument for an endoscope according to any one of claims 1 to 5, wherein the sliding contact outer peripheral surface and the sliding contact portion do not slide.   When the distal treatment member is at the most advanced position within the range movable in the axial direction relative to the distal end cap and at the rear end position, the sliding contact outer peripheral surface and the sliding contact portion do not slide. The endoscope treatment tool according to any one of claims 1 to 5.   When the distal treatment member is in the most advanced position within the range movable in the axial direction with respect to the distal end cap, the sliding contact outer peripheral surface and the sliding contact portion are not in sliding contact but are in the rear end position The treatment instrument for an endoscope according to claim 1, wherein the sliding contact outer peripheral surface and the sliding contact portion are in sliding contact.   The operation wire is formed of a stranded wire, and the outer peripheral surface for sliding contact is formed by attaching a sticking agent to an outer peripheral portion near the tip of the operation wire and finishing the outer peripheral surface to a smooth surface. Item 9. The endoscopic treatment tool according to any one of Items 1 to 8.   The endoscopic treatment tool according to any one of claims 1 to 8, wherein the sliding contact outer peripheral surface is formed by a surface of a cylindrical body attached to an outer periphery of a distal end portion of the operation wire.

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