JP5437778B2 - Medical treatment tool - Google Patents

Description

  The present invention is a rope for operation by twisting after a certain mechanical processing and low-temperature heat treatment are provided on the metal wire, improving mechanical strength characteristics such as tensile breaking strength, and improving operability. The present invention relates to a medical treatment instrument characterized by the above.

  The distal end of the medical treatment instrument inserted into the body or the hand operating section transmits the hand operation to the distal end via the operating rope, so the mechanical strength characteristics of the operating rope joined to the connecting member are taken into account. In order to treat the lesioned part, it is necessary to satisfy the safety of the human body. For this reason, various proposals have been made.

  Patent Document 1 describes a flexible effect by using a stranded wire made of stainless steel as an operation wire of the biological tissue clip device. However, which steel type made of stainless steel is used, the metal wire constituting the operation rope, and the relationship between the heat treatment temperature of the operation rope after twisting the metal wire and the tensile strength at break Is not specified at all.

  In Patent Document 2, as a rope for operation of a medical treatment instrument, the lower layer of the lower twist and the outer layer of the upper twist are in parallel twist and twisted form, and the outer layer is an alternating arrangement of thick and thin wires, particularly improving the rotational operability. There is a description to make. However, nothing is clearly shown about the metal strands constituting the operation rope in the same manner as described above, and the heat treatment temperature and tensile breaking strength characteristics of the operation ropes after the metal strands are twisted together.

Patent Document 3 discloses a joining technique in which a bending operation wire and an insertion tip are “brazed and fixed” in a vacuum environment or an inert gas environment as an endoscope, and the bending operation wire is disconnected due to the occurrence of rust. The purpose is prevention.
However, in general, for example, gold brazing (JIS Z3266) having a melting point of 895 ° C. to 1030 ° C. is used for brazing stainless steel, and in such a case, the metal strands that constitute the bending operation wire are melted and welded. In addition, there is no disclosure of brazing material in such a patent document, and there is no disclosure about the correlation between the melting temperature of the brazing material and the mechanical strength characteristics of the bending operation wire. This is an idea of using brazing as a simple means of fixing.

JP 2002-301082 A Japanese Patent No. 4084245 JP 2001-149307 A

The present invention was made in order to solve the above-mentioned problems, and the tensile strength at break due to the thermal effect of a metal element wire that has been subjected to strong drawing using a commercially available austenitic stainless steel wire. In terms of the correlation between the tensile breaking strength characteristics of each process and the low-temperature heat treatment in the production of metal wires, it is highly tensile by accumulating processes that have the effect of improving the tensile breaking strength characteristics of the metal strands. Disclosed are a medical treatment instrument composed of a rope twisted using a metal strand having an increased breaking strength, and a method for manufacturing the same.
And if it supplements, the said joining member utilizes the fusion | melting heat of the joining member which joins the rope for operation and a connection member, and the effect of a tensile breaking strength characteristic improvement by the heat influence to the metal strand which carried out the strong work drawing process. Medical that can be operated safely by the surgeon by disclosing not only the fixing means but also a new joining technical idea that improves the joint strength while improving the tensile breaking force of the operating rope It is in providing a treatment tool. In the heat treatment of the present invention, the reduction in tensile fracture strength, the annealing that softens the steel wire by reducing the hardness, or the low temperature annealing, and the normalization that heats above the transformation point (eg, Ac3 about 730 ° C. or higher) Differently, it is called “low temperature heat treatment” and distinguished from heat treatment that increases the tensile strength at break and improves mechanical properties.

The invention according to claim 1 is provided with a distal treatment section on the distal end side of the flexible tube and a proximal operation section on the proximal side, and an operation rope inserted through the flexible tubular body is provided in the distal treatment section. In the medical treatment instrument that is connected to the hand operation unit, and pushes, pulls, or rotates the hand operation unit to transmit the operation force of the operation rope to operate the distal treatment unit, The rope for operation is formed by twisting a plurality of metal strands having a strand diameter of 0.008 mm to 0.200 mm. The metal strand is subjected to a solution treatment and contains Mo as a component. No austenitic stainless steel wire is used, a low temperature heat treatment of 180 to 495 ° C. is provided after drawing and drawing, or the metal strand is subjected to a solution treatment and contains Mo as a component using a stainless steel wire, wire drawing and wire drawing Provided low-temperature heat treatment of 525 ° C. from 180 ° C. to perform the final drawing after repeating at least one set or more of the low-temperature heat treatment and the drawing as one set, the total area reduction rate of up to the final drawing 95% to 99.5% or less, the total increase rate of the tensile breaking strength by the low-temperature heat treatment until the final wire drawing is 10% or more, and Y: tensile breaking strength (kgf / mm @ 2), X: When the total area reduction (%)
Satisfies the relational expression of Y ≧ 2.000X + 70,
A medical treatment instrument comprising an operation rope using the metal element wire.
By this configuration, by performing low-temperature heat treatment in a temperature range where the tensile breaking strength of the drawn metal wire steeply increases, performing strong wire drawing and low-temperature heat treatment, or accumulating this It is possible to provide a medical treatment instrument that can be operated safely by an operator using an operation rope having a high strength tensile breaking strength obtained by twisting a metal strand having a high strength tensile breaking strength. .

According to a second aspect of the present invention, in the medical treatment instrument according to the first aspect, at least one set of the wire drawing and the low-temperature heat treatment of the operation rope is a primary wire drawing. When the metal strand is an austenitic stainless steel wire that does not contain Mo in its component, a primary low-temperature heat treatment is performed at 180 ° C. to 495 ° C. after the primary wire drawing. Alternatively, when the metal strand is an austenitic stainless steel wire containing Mo as a component, a primary low-temperature heat treatment is performed after the primary wire drawing at 180 ° C. to 525 ° C. When the metal wire is an austenitic stainless steel wire that does not contain Mo as a component, the rate of increase of the steel is 6% or more, the area reduction rate of the secondary wire drawing is 40% to 79%. By providing secondary low-temperature heat treatment of 495 ° C. from 180 ° C. after the secondary wire drawing, or the metal wire is, when the austenitic stainless steel wire containing Mo at its components, from 180 ° C. after the secondary wire drawing Provided with a secondary low-temperature heat treatment at 525 ° C., and the rate of increase in tensile fracture strength due to the secondary low-temperature heat treatment is 4% or more, comprising a rope for operation using the metal strand, It is a treatment tool.
With this configuration, it is possible to increase the generation of work-induced martensite that contributes to the effect of improving tensile fracture strength, and wire drawing with high surface area reduction and low-temperature heat treatment in a temperature range where the tensile fracture strength increases steeply. By accumulating, an operation rope having a high strength tensile breaking force can be obtained.

The invention according to claim 3 is the medical treatment instrument according to any one of claims 1 or 2, wherein the operation rope is configured to be twisted using a plurality of the metal strands. A medical use characterized by comprising a rope for operation using the metal wire, characterized in that it is provided with a low-temperature heat treatment for a short time and is increased more than the tensile breaking force before the short-time low-temperature heat treatment. It is a treatment tool.
With this configuration, after twisting a plurality of metal strands having high strength tensile breaking strength characteristics, a short time low-temperature heat treatment is applied in a temperature range where the tensile breaking strength steeply increases and increases. As a result, a rope for operation having a higher tensile breaking force and operability can be obtained.

According to a fourth aspect of the present invention, in the operation rope, the metal element wire is used as a core material and a side material, and 6 to 9 side materials are wound in a one-way spiral around the outer periphery of the core material. It is composed of a spiral rope having a twisted configuration that is formed by rotation, the strand diameter of the core material is 1.07 to 2.12 times the strand diameter of the side member, and the operation rope using the metal strand It is comprised, The medical treatment tool as described in any one of Claim 1 to 3 characterized by the above-mentioned.
With this configuration, it is possible to provide a medical treatment instrument that uses the operation rope with improved tensile breaking force to improve the operation force transmission performance to the distal end portion, particularly by pushing and rotating operations.

According to a fifth aspect of the present invention, in the medical treatment instrument according to any one of the first to fourth aspects, a plurality of bending pieces are connected to the distal treatment section, and the bending piece and the operation on the distal end side are connected. consists curved portion which connects the front end portion of the use ropes, by transduction activity of the operating force of said operating rope by operating the operation portion, a medical endoscope is curved deform the curved portion.
With this configuration, the tensile breaking force of the operating rope is improved, and even when the operating force is increased, the rope can be expanded as the tensile breaking force is increased. The responsiveness of the bending deformation operation of the part is improved, and the hardness of each metal wire increases with the increase in strength of the tensile breaking force. Wear characteristics can be improved. Then, it is possible to eliminate the interruption of the operator's procedure in the inoperable state due to the insufficient mechanical strength of the operating rope, and to provide a medical endoscope having a high degree of operability.

According to a sixth aspect of the present invention, in the medical treatment instrument according to any one of the first to fourth aspects, the operating force of the operating rope is reduced by pushing, pulling, or rotating the hand operating section. A treatment instrument for medical endoscope which, after transmitting or expanding or contracting the treatment loop of the distal treatment section, transmits a high-frequency current to the manipulation rope and the distal treatment section to excise the affected area. medical endoscopes snare, or medical endoscope high-frequency snare, and the invention according to claim 7, the medical treatment instrument according to any one of claims 1-4, wherein the hand By pushing, pulling, or rotating the operation portion to transmit the operation force of the operation rope, the forceps cup of the biopsy forceps of the distal treatment portion is opened and closed to collect a living tissue, or the forceps cup is After opening and closing, the operation rope and the forceps A medical endoscope forceps or medical endoscope hot biopsy forceps, medical endoscope treatment tool to excise the diseased part by applying a high frequency current to.
This configuration prevents interruption of the operator's procedure in an inoperable state due to insufficient tensile rupture strength of the operating rope, and facilitates the expansion / contraction of the loop of the distal treatment section or the opening / closing action of the biopsy forceps cup. Medical endoscope snare, medical endoscope high-frequency snare, and medical endoscopy that can perform rapid procedures such as excision of affected part or collection of living tissue and hemostasis while maintaining high operability It is possible to provide a medical endoscopic treatment tool for a forceps for a mirror and a hot biopsy forceps for a medical endoscope.

According to an eighth aspect of the present invention, there is provided the medical treatment instrument according to any one of the first to fourth aspects, wherein the operating force of the operating rope is reduced by pushing, pulling, or rotating the hand operating section. The medical treatment tool is a medical endoscope clip device for a medical endoscope treatment tool in which the clip of the distal treatment section is detached and placed in the body by a transmission action.
With this configuration, even if the tension of the rope for operation is increased by providing multiple clips for the distal treatment section, it prevents inoperability due to insufficient tensile breaking strength, smoothing the clip detachment operation, and quick procedure response. It is possible to provide a medical endoscope treatment tool with a clip device.

The invention according to claim 9 is the medical treatment instrument according to any one of claims 1 to 4 , wherein the operation force of the operation rope is transmitted by pushing, pulling, or rotating the hand operation unit. Medical treatment of a medical endoscopic treatment tool that causes high-frequency current to flow through the operation rope and the knife section while cauterizing and incising the affected living body tissue while guiding the knife section of the distal treatment section to a desired position. This is a high-frequency knife for an endoscope.
This configuration prevents the operator from interrupting the operation in an inoperable state due to insufficient tensile breaking force of the operating rope, and improves the smooth operability to the knife portion of the distal treatment section, It is possible to provide a high-frequency knife medical endoscope treatment tool that can quickly handle hemostasis and the like.

The perspective view which shows the whole medical treatment tool (medical endoscope) of this invention. Sectional drawing which looked at the insertion part front end side of the medical treatment tool (medical endoscope) of this invention from the side. The assembly | attachment figure of the bending piece of the front-end | tip of the medical treatment tool (medical endoscope) of this invention, and the rope for operation. The assembly | attachment figure of the bending piece of the front-end | tip of the medical treatment tool (medical endoscope) of another Example (connecting member of a tubular rope receiver), and the rope for operation. The block diagram of the rope for operation used for the medical treatment tool of this invention. Total area reduction ratio and tensile breaking strength characteristic diagram. The temperature and tensile breaking strength characteristic figure of the metal strand used for the rope for operation. The block diagram of the snare for medical endoscopes, and the high frequency snare for medical endoscopes. The forceps for medical endoscopes and the hot biopsy forceps configuration diagram for medical endoscopes. The block diagram of the clip apparatus for medical endoscopes. The block diagram of the high frequency knife for medical endoscopes. The relationship figure of the tensile breaking strength of a metal strand, and an area reduction rate.

An embodiment of the present invention will be described with reference to the drawings.

FIG. 1 shows an overall perspective view of a medical endoscope 1 that is a medical treatment instrument according to a first embodiment of the present invention. The medical endoscope 1 includes a hand operation unit 2 and a hand operation unit 2. An elongated insertion portion 4 connected to the distal end and inserted into the body, and a treatment tool hole that allows the medical endoscope treatment tool 11 of the medical endoscope 1 to enter and exit from the hand portion of the operation portion 2. 10 and a universal cord 8 having a connector 9 detachably connected to a light source device (not shown). The hand operation unit 2 is provided with a bending operation knob 3 for freely bending the distal end portion and a remote switch 12 for controlling a video processor (not shown).
The insertion portion 4 has a structure in which the flexible tube portion 5, the bending portion 6, and the tip configuration portion 7 are connected in series from the hand portion. The medical treatment tool of the present invention refers to both a medical endoscope and a medical endoscope treatment tool. The medical endoscope treatment tool includes a snare, a forceps, a clip, a high-frequency knife, and the like, which will be described later. Refers to the treatment tool.

The distal treatment section in FIG. 2 is composed of a bending section 6 and a distal end constituting section 7. The bending section 6 has a plurality of short cylindrical bending pieces 18 arranged in series and connected rotatably via a rivet 19. Each bending piece 18 is cut inwardly on an arc at an intermediate portion in the axial direction of a short cylinder at a portion substantially orthogonal to the axial direction of the rivet 19 to form a pair of rope receivers 22.
The operation rope 20 is inserted through the rope receivers 22 inside the plurality of bending pieces 18, and is joined using the joining member 21 at the most advanced distal bending piece 18a and the connecting member 22a of the distal rope receiver. Yes.
Then, the proximal portion of the operation rope 20 is inserted through the insertion portion 4 and the proximal operation portion 2 up to the bending operation knob 3 of the proximal operation portion 2 shown in FIG. The bending portion 6 can be bent up and down in FIG. 2 by pulling and pulling the operation rope 20 by rotating the operation knob 3. If another pair of rope receivers (not shown) are arranged in the front and back directions in FIG. 2 orthogonal to the pair of upper and lower rope receivers 22 in FIG. The structure can be bent in four directions. Such a structure may be used.
The outer periphery of the bending piece 18 is constituted by a blade 23 braided with a wire, and the outer periphery thereof is covered with an outer tube 24 made of synthetic resin.

  In the distal end configuration portion 7, an image guide fiber 26 is inserted into the base tube 25, and an objective lens 27 is disposed on the distal end side. The channel tube 28 connected to the connection pipe 29 is connected to the treatment tool hole 10 leading to the hand portion of the hand operation unit 2, and in addition to forceps such as biopsy forceps, a high-frequency snare, Various medical endoscope treatment tools 11 such as a clip device and an injection needle can be moved in and out, so that a lesion can be treated.

  FIG. 3 shows an assembled view of the most advanced tip bending piece 18a and the operating rope 20. The tip bending piece 18a is cut in an arc shape inward at a substantially middle portion of the short cylindrical long axis direction to form a protruding shape. The operation rope 20 is inserted into the connecting member 22a of the pair of distal end rope receivers, and the distal end portion 20a of the operating rope 20 is joined using the joining member 21 at the connecting member 22a of the distal end rope receiver.

And the operation rope 20 used for the medical treatment tool of the present invention uses a spiral rope or a strand rope described later, and FIGS. 5A and 5A show the medical endoscope of the first embodiment of the present invention. An embodiment of the spiral rope of the operation rope 20 to be used will be shown.
The operation rope 20 of the embodiment of the present invention is formed by twisting a plurality of metal strands having a strand diameter of 0.008 mm to 0.200 mm, and in the operation rope 200 of the spiral rope embodiment A, A core material 200A is composed of a core material 200A having one metal strand having a strand diameter (wire diameter) of 0.13 mm and six metal strands having a strand diameter (wire diameter) of 0.11 mm. The side material 200B is twisted on the outside, and the twisting direction is continuous with respect to the longitudinal direction to form a one-way spiral winding, that is, the spiral rope twisting structure 1 × 7 (core The outer rope diameter D after twisting is 0.35 mm, and the rope pitch (P in the drawing) is 2.5 to 15 times the outer rope diameter D. Here, the spiral rope is a rope formed by twisting three or more metal strands into a strand (bundle), and is named (1 × n), where n is the number of metal strands. Show.

  And the metal strand used for the rope for operation is a temperature at which the wire drawing process having a predetermined area reduction rate using a solidified austenitic stainless steel wire and the tensile property is increased sharply and the mechanical properties are improved. After performing at least one set of low temperature heat treatment in the temperature range matched with the region, the final wire drawing is performed, and the total area reduction until the final wire drawing is 95% to 99.5%. It is characterized in that the final finished metal element has a certain tensile strength at break. In addition, the area reduction rate here refers to the difference in cross-sectional area between the wire diameter before wire drawing and the wire diameter after wire drawing in one wire drawing process, and the total area reduction rate. Is the wire diameter before wire drawing of the wire material (for example, wire material having a tensile breaking strength of 60 to 80 kgf / mm 2) using the solidified wire material, and the finish after the final wire drawing step after each wire drawing step This refers to the difference in cross-sectional area between the wire diameter and the reduction rate.

Here, the low temperature heat treatment in the temperature range matched with the temperature range in which the tensile breaking strength increases sharply and improves the mechanical properties is the reason for the metal wire having a total area reduction ratio of 95% or more described later. In FIG. 7 and FIG. 12 showing the tensile breaking strength characteristics under the influence of heat, a low-temperature heat treatment is performed in such a temperature range, a wire drawing process and the low-temperature heat treatment are performed, and this is accumulated. This is because the tensile strength at break can be dramatically increased.
Accordingly, the “low temperature heat treatment” as used in the present invention is a heat treatment for annealing at a lowering of tensile strength and softening due to a decrease in hardness, or normalizing at a temperature higher than the transformation point (eg, Ac3: about 730 ° C. or higher). It is different from heat treatment.

The reason why the wire drawing and the low-temperature heat treatment are set as at least one set is described later. For example, the operation rope Example A according to the present invention, which is made into one set, is a comparative example 1 only for wire drawing. On the other hand, the tensile breaking strength can be further increased, and further, the tensile breaking strength can be dramatically increased in the case of Examples B and C in which two sets are formed.
Also, the reason why the total area reduction is 95% or more is that there is an inflection point where the tensile breaking strength increases when the total area reduction is 80% or 90% or more (FIG. 6, spring third plate). Maruzen Co., Ltd., p. 63, FIG. 2.82), when the total area reduction ratio reaches 95%, it becomes an inflection point that increases dramatically.
In addition, the total area reduction ratio is set to 99.5% or less because with a high degree of wire drawing that exceeds this, voids begin to form in the metal structure and the embrittlement is remarkable, and the metal is formed as a rope when twisted. This is because breakage of the strands is likely to occur.

  And, the reason why the austenitic stainless steel wire was drawn was to obtain a highly workable austenitic structure, and the austenitic stainless steel wire was refined by heat treatment using transformation points. This is because crystal grains can be refined only by cold working, and the tensile breaking strength can be improved by exhibiting remarkable work hardening by wire drawing. The reason for using austenitic stainless steel wire is that martensitic stainless steel wire exhibits quench hardenability by heat treatment and is easily affected by heat, and precipitation hardened stainless steel wire (SUS630, etc.) has insufficient toughness and is twisted. This is because a wire breakage occurs during wire processing, and a twisted configuration of fine wires and extra fine wires cannot be formed as in the above-described embodiment, and a ferritic stainless steel wire has a problem of temperature brittleness (sigma brittleness).

  As a supplement, it is desirable to set the area reduction rate of the primary wire drawing process to be higher than the area reduction rates of other wire drawing processes. This is because it is possible to increase the production of work-induced martensite that greatly contributes to an increase in tensile strength at break.

Here, Tables 1 and 2 show the high tensile tensile strength at which the wire diameter of the metal wire of the present invention is 0.008 mm to 0.200 mm (0.11 mm and 0.13 mm differing in the manufacturing process in this embodiment). The manufacturing process for obtaining the metal strand which has a characteristic, and the tensile breaking strength characteristic etc. are shown for every process.
This is because a solidified austenitic stainless steel wire is used, a wire with a tensile breaking strength of 70 kgf / mm2 to 75 kgf / mm2 (base material), wire drawing with a predetermined area reduction rate and low-temperature heat treatment are performed. Repeat at least one set as one set.
And, in the case of two sets, the primary wire drawing is performed at a predetermined surface reduction rate with the highest surface drawing rate of the primary wire drawing, and then the heat treatment furnace at a temperature range of 180 ° C. to 525 ° C. for 10 minutes to 180 minutes. Is subjected to primary low-temperature heat treatment by atmospheric heating, followed by secondary wire drawing at a predetermined area reduction rate lower than the primary wire drawing, and heat treatment for 10 minutes to 180 minutes at a temperature range of 180 ° C. to 525 ° C. A secondary low-temperature heat treatment by atmospheric heating using a furnace is performed, and then a predetermined tertiary wire drawing is performed at a surface reduction rate lower than that of the primary wire drawing as described above to obtain a metal strand having a predetermined finished wire diameter. it can.

  Specifically, the core material 200A of the operation rope 200 of Example A has a wire diameter of 0.183 mm by using a plurality of dies for an austenitic stainless steel wire having a wire diameter of 0.58 mm. The primary wire drawing process is performed until the tensile breaking strength increases sharply, and then the primary low-temperature heat treatment by atmospheric heating using a heat treatment furnace at a temperature range of 180 ° C. to 495 ° C. for 10 minutes to 180 ° C. (450 ° C. in this example) , 30 minutes), and then secondary wire drawing (final wire drawing) until the wire diameter is 0.13 mm, the total area reduction is 95%, and the work hardening and tensile breaking strength of the wire drawing work are increased. The tensile strength at break can be improved from 70 kgf / mm @ 2 to 268 kgf / mm @ 2 by low-temperature heat treatment in the increasing temperature range. Further, the side material 200B is substantially the same as the core material 200A.

  Further, the core material 201A of the operation rope 201 according to the embodiment B of the present invention has a wire diameter of 0.23 mm by using a plurality of dies for an austenitic stainless steel wire having a wire diameter of 0.76 mm. After performing the primary wire drawing until it becomes, and then performing the primary low-temperature heat treatment in the same temperature range as in Example A, the secondary wire drawing is performed until the wire diameter is 0.168 mm, and then the same temperature range as described above. Then, after the secondary low-temperature heat treatment (450 ° C., 30 minutes in this embodiment) is applied, and the third wire drawing (final wire drawing) is performed to a wire diameter of 0.13 mm, the total area reduction rate is 97.1. %, Core material 201A having higher tensile strength at break can be obtained. The side material 201B is substantially the same as the core material 201A.

  Then, the rope 202 for operation composed of the core material 202A and the side material 202B having a total area reduction rate of 99.5% by the same manufacturing method as in Example B is set as Example C, and the tensile breaking strength increases steeply. Table 1 is a summary of the manufacturing process of the core material and side material of Examples A to C and Comparative Example 1, with the rope 203 for operation only for wire drawing without adding a low-temperature heat treatment to be performed as Comparative Example 1. It becomes. In addition, the material of Examples A to B and the core material of Comparative Example 1 and the metal element wire of the side material is SUS304 material of austenitic stainless steel wire, and the core material and side material of Example C are used. As the material of the metal wire, a SUS316 material as a remelting material was used. The tensile breaking strength referred to here is a value obtained by dividing the maximum value when a tensile force is applied to the wire rod by the cross-sectional area of the wire rod.

  According to Tables 1 and 2, the rate of increase in tensile fracture strength A due to the primary low-temperature heat treatment of the core material 200A and the side material 200B of Example A with “one set of wire drawing and low-temperature heat treatment” 13.6%, exceeding 6% and showing an increase rate of 10% or more. The tensile strength at break after the final wire drawing step (secondary wire drawing in this embodiment) is 268 kgf / mm 2 and 270 kgf / mm 2, respectively, and both values are 260 kgf / mm 2 or more.

  And the increase rate A of the tensile fracture strength by the primary low-temperature heat treatment of the core material 201A and the side material 201B of Example B in which “the wire drawing process and the low-temperature heat treatment are two sets” is 14.3%. Increase rate of 10% or more. The rate of increase in tensile fracture strength due to secondary low-temperature heat treatment was 5.8%, indicating an increase rate of 4% or more. + B) is 20.1% in all cases, exceeding 10% and showing an increase rate of 15% or more. The tensile breaking strengths after the final wire drawing step (third wire drawing in this embodiment) are 306 kgf / mm 2 and 312 kgf / mm 2, respectively, which are values of 290 kgf / mm 2 or more.

  Further, as in the case of Example B, the rate of increase in tensile fracture strength I by the primary low-temperature heat treatment of the core material 202A and side material 202B of Example C is 19.1% and 19.2%. Both show an increase rate of 10% or more. In addition, the increase rate of tensile rupture strength by secondary low-temperature heat treatment was 9.5%, indicating an increase rate of 4% or more, and the total increase rate of tensile rupture strength by each low-temperature heat treatment. (A + B) was 28.6% and 28.7%, indicating an increase rate of 15% or more. The tensile breaking strengths after the final wire drawing step (third wire drawing in this embodiment) are 402 kgf / mm @ 2 and 400 kgf / mm @ 2, respectively, which are values of 350 kgf / mm @ 2 or more.

  The difference between Examples A and B is that Example B has two sets of the wire drawing step and low-temperature heat treatment, and the area reduction rate and total area reduction rate of primary wire drawing are higher than Example A. In addition, the difference between Example B and C is that in Example C, the area reduction ratio and the total area reduction ratio of the primary wire drawing are higher than those in Example B, and the difference in the steel type is SUS316 using a remelted material. is there.

  Here, the area reduction ratio in the primary wire drawing process is 80% to 94% (90% to 93.8% in this embodiment), and 85% to 94% in order to obtain higher tensile strength characteristics. The area reduction rate of the secondary wire drawing is from 40% to 79% (46.6% to 75% in this example), and from 45% to 79% in order to obtain higher tensile breaking strength characteristics, The area reduction rate in the wire drawing process is set higher than the area reduction after the secondary wire drawing, and the total area reduction until the final wire drawing process is 95% or more and 99.5% or less. In order to obtain the characteristics, the content is set to 97% or more and 99.5% or less.

And when wire drawing and low-temperature heat treatment are performed as one set and the final wire drawing is then provided as in Example A, the total area reduction rate of the metal wire is X (%). The relational expression with the tensile breaking strength Y (kgf / mm @ 2) is (1) below.
Relational expression: Y ≧ 2.000X + 70 (1)
In the relational expression (1), since the total area reduction ratio X of the core material 200A is 95%, the tensile breaking strength Y is 260 kgf / mm 2 or more, and the tensile breaking strength of the core material 200A in Example A is 268 kgf. Therefore, the relational expression (1) is satisfied.
And next, as in the case of Example B, when the wire drawing and the low-temperature heat treatment were performed as two sets and the final wire drawing was then performed, the total area reduction rate of the metal wire was expressed as X (%). Then, the relational expression with respect to the tensile breaking strength Y (kgf / mm @ 2) of the metal strand becomes (2) below.
Relational expression: Y ≧ 2.268X + 70 (2)
In the relational expression (2), since the total area reduction ratio X of the core material 201A is 97.1%, the tensile breaking strength Y is 290 kgf / mm 2 or more, and the tensile breaking strength of the core material 201A in Example B is above. Is 306 kgf / mm @ 2 and satisfies the relational expression (2).
Further, in Example C which has the highest tensile breaking strength among the present Examples, the following relational expression (3) is obtained.
Relational expression: Y ≧ 2.763X + 75 (3)
In the relational expression (3), since the total area reduction ratio X of the core material 202A is 99.5%, the tensile breaking strength Y is 350 kgf / mm 2 or more, and the tensile breaking strength of the core material 202A in Example C is above. Is 402 kgf / mm @ 2 and satisfies the relational expression (3).

As described above, each example of the present invention dramatically increases the tensile breaking strength compared to Comparative Example 1, and in each Example, unlike Comparative Example 1, the tensile breaking strength increases steeply and the mechanical properties are increased. By performing low-temperature heat treatment in a temperature range that improves the wire drawing process and performing the low-temperature heat treatment, and accumulating these, and also reducing the reduction rate of the metal wire in the primary wire drawing process to other A metal strand having a high tensile strength at break can be produced by selecting a steel type that is set higher than the wire drawing process and that is more suitable for a strong wire drawing process.
FIG. 12 shows the relationship between the tensile breaking strength Y (kgf / mm @ 2) of the metal wire and the total area reduction ratio X (%). In the figure, symbol i represents relational expression (1), symbol b represents relational expression (2), symbol c represents relational expression (3), and symbol d represents the case of comparative example 1.

In addition, the temperature range of each of the primary and secondary low-temperature heat treatments is 180 ° C. to 525 ° C. for 10 minutes to 180 minutes (450 ° C., 30 minutes in this embodiment). Stainless steel wire, for example, SUS304 material and SUS316 material are in the temperature range where the tensile breaking strength in the strong wire drawing process increases steeply, and the productivity and quality stability by atmospheric heating using a heat treatment furnace This is because of consideration.
Five or more sets of wire drawing and low-temperature heat treatment may be provided as one set, but three sets or less are desirable from the viewpoint of economy, productivity, and the like. Also, the reason why the low temperature heat treatment is not provided after the final wire drawing at the stage of the metal wire (after the third wire drawing in Example C) is that the tensile strength at break is Although it increases, since the elongation is insufficient due to the strong wire drawing, the metal strands are easily broken when twisted as a rope using a plurality of the metal strands, and this is prevented. This is considered as a peculiar phenomenon in which the total area reduction rate exceeds 95%. And the low-temperature heat processing after twisting structure as a rope is mentioned later.

Next, FIG. 7 shows that the austenitic stainless steel wire is generally used as the metal wire, and the metal wire after the final wire drawing with a total area reduction of 95% or more is subjected to heat (30 minutes for each temperature). FIG. 5 is a diagram showing the tensile breaking strength characteristics of FIG. 5 and is shown in the figure for SUS304 material and shown in the figure for SUS316 material.
According to this, SUS304 material begins to increase in tensile rupture strength due to the heat effect at 180 ° C and steeply slopes, and shows the highest tensile rupture strength property in the vicinity of 450 ° C. When the temperature exceeds 520 ° C., the tensile strength at break is lowered more rapidly than normal temperature (20 ° C.). The SUS316 material containing Mo shows the same tendency as the SUS304 material on the low temperature side, but shows the highest tensile rupture strength characteristics at about 480 ° C. on the high temperature side, and the effect of improving the tensile rupture strength properties to 525 ° C. is remarkable. In addition, when the temperature exceeds 540 ° C., the tensile strength at break decreases more rapidly than normal temperature (20 ° C.).
The reason why the tensile strength at break is abruptly decreased is that, as described above, when the austenitic stainless steel wire subjected to the solution treatment is heated from 800 ° C. to 800 ° C., the carbon This requires energy for precipitation and migration of chromium, causing a sensitization phenomenon. In particular, in an ordinary SUS304 austenitic stainless steel wire having a carbon content of 0.08% or less, the temperature is about 700 ° C. for about 4 to 5 minutes. This is because a sensitization phenomenon appears and the tensile strength at break is extremely reduced.

Since it has such tensile breaking strength characteristics, the temperature range of the low-temperature heat treatment of the metal wire of SUS304 material is desirably a temperature range of 180 ° C. to 495 ° C. in which the tensile breaking strength increases sharply, and includes Mo. For example, the temperature range of the low-temperature heat treatment of a metal strand made of SUS316 material (Mo is 2 wt% to 3 wt%) is desirably 180 ° C. to 525 ° C.
As described above, the present invention focuses on the tensile strength at break due to the temperature of the austenitic stainless steel wire having a high total area reduction ratio after the strong wire drawing, and the metal strand used for the operation rope 20 is A new technical concept that can greatly improve the tensile breaking force of the rope in the twisted state of the metal wire of the operation rope, paying attention to the fact that it is easy to be affected by heat with a small heat capacity with thin wire / extra fine wire Is to provide. The tension breaking force of the rope here means the maximum load when the rope is broken by applying a tensile force to the rope.

  And the chemical component of the austenitic stainless steel wire of the metal strand used for a present Example is C: 0.15% or less, Si: 1% or less, Mn: 2% or less, Ni: 6% -16 in weight%. %, Cr: 16% to 20%, P: 0.045% or less, S: 0.030% or less, Mo: 3% or less, the balance being iron and inevitable impurities. Thus, high strength austenitic stainless steel can be obtained by using the above method without using high silicon stainless steel (Si: 3.0% to 5.0%) or precipitation hardening stainless steel wire (SUS630 or the like). A metal wire of a steel wire can be obtained. C is preferably 0.005% or more for improving the tensile strength at break, and is preferably 0.15% or less from the viewpoint of suppressing intergranular corrosion.

The core material or side metal wire used in the operation rope 20 of the medical endoscope 1 of the present invention is an austenitic stainless steel wire having a wire diameter of 0.008 mm to 0.200 mm, particularly metal In order to enable wire drawing with a wire diameter of 0.130 mm or less, a tensile breaking strength of 350 kgf / mm 2 or more, and a total area reduction of 97% or more, SUS304 material using a remelting material, Or SUS316 material is desirable.
The reason for this is that the cause of disconnection when drawing a stainless steel wire is most often oxide inclusions as well as surface flaws, and this tendency becomes more prominent as the wire becomes finer and finer.
And the chemical component is low in the components of Al, Ti, Ca and O which are inclusion generating elements, and also suppresses S which causes a decrease in wire drawing due to the action of sulfide. The specific chemical components of the austenitic stainless steel wire are, by weight, C: 0.08% or less, Si: 0.10% or less, Mn: 2% or less, P: 0.045% or less, S: 0 0.010% or less, Ni: 8% to 12%, Cr: 16% to 20%, Mo: 3% or less, Al: 0.0020% or less, Ti: 0.10% or less, Ca: 0.005% or less , O: 0.0020% or less, with the balance being Fe and inevitable impurities.
And as a manufacturing method of a remelting material, it is the manufacturing method etc. of the electroslag remelting which used the flux for the ingot after melting of stainless steel. Even when a triple melting material is used, the same effect as described above can be obtained.

  And then, a temperature range that shows a more remarkable effect in the temperature range where the tensile breaking strength sharply increases on the operation rope after being twisted and configured using a plurality of strongly drawn wire elements. By adding a short low-temperature heat treatment of 300 to 525 ° C. for 2 seconds to 10 minutes (in this embodiment, 2 seconds and 60 seconds at 450 ° C.), the tensile breaking force of the rope for operation is increased and the operation is increased. Can be improved. Table 3 compares the tensile breaking strength of the ropes when the heating time is changed at 450 ° C. to the operation ropes 200, 201, and 202 of Examples A to C.

According to Table 3, the tensile breaking force of the operating rope 200 increased from about 24.1 kgf to 24.9 kgf by about 3.5% even when heating at 450 ° C. for 2 seconds at low temperature, Similarly, in the case of the operation rope 201, the increase is about 3.6%, and in the case of the operation rope 202, the increase is about 3.9%, and the increase rate of the tensile breaking force increases as the total area reduction ratio increases. Tend to.
The term “short-time low-temperature heat treatment” as used herein means that the mechanical strength increases when the tensile breaking force increases within 300 seconds to 525 ° C. within 2 seconds to 10 minutes, and within 300 ° C. to 550 ° C. within 2 seconds to 10 seconds. It refers to heat treatment that improves the mechanical properties.
And the construction method is a spinner straightening machine that imparts a known bending and twisting strain to the twisted rope, and atmosphere heating using a heat treatment furnace to the twisted rope, or bright heat treatment in an inert gas, or It is a method of applying the atmosphere heating or bright heat treatment after straightening with a leveler type straightening machine or the like.
And by using the said construction method, the tensile breaking force of the rope for operation can be improved, and linearity can be improved, and the operativity of a medical treatment tool can be improved more. The reason for this can be considered that the concentrated stress generated locally in the operation rope is averaged by performing the short-time low-temperature heat treatment after twisting or straightening.

  As described above, in order to obtain a remarkable effect of improving the tensile breaking force by low-temperature heat treatment or short-time low-temperature heat treatment, the total area reduction ratio of the metal strands used for the operation rope is 95% to 99%. .5% is desirable, preferably 97% to 99.5%. The reason for this is that the metal strands having a total area reduction of over 99.5% are extremely short in elongation, and disconnection of the metal strands of the side material is particularly likely to occur during twisting.

An embodiment of another spiral rope of the operation rope 20 of the present invention is shown in FIGS. FIGS. 5B to 5E show Examples D to G, respectively, and the twist configuration of the spiral rope is 1 × 8, 1 × 9, 1 × 10, and 1 × 19, respectively. Further, although not shown as another embodiment, it is 1 × 3, 1 × 12, or the like.
The core diameters of the metal wires of the core material and the side material are both 0.008 mm to 0.200 mm, and the core material and the side material are formed by twisting and forming metal wires having the same wire diameter. May be. In addition, when arranging the wire diameter (wire diameter) and the wire diameter ratio (core material / side material) of the core material and the side material of the other examples of the examples D to F and the twist configuration 1 × 7, It becomes Table 4.

According to Table 4, for example, Example F (illustration (D)) has a twist configuration of 1 × 10, the core material is one metal strand having a wire diameter of 0.18 mm, and the side material has a wire diameter of 0.1. It consists of nine 085 mm metal strands and the wire diameter ratio is 2.12. Similarly, in another embodiment of the twisted configuration 1 × 7, the core material has a wire diameter of 0.122 mm, the side material has a wire diameter of 0.114 mm, and the wire diameter ratio is 1.07.
And as shown in the said each Example, the wire diameter of the core material uses the large diameter wire 1.07 times to 2.12 times the wire diameter of the side material. The same wire diameter may be used for both the core material and the side material, but the reason for using a thick wire for the core material is that when a tensile force is applied to the operating rope 20, the tensile force applied to one core material is More than the side material composed of several pieces, the structural difference is greater (the side material is a spiral structure that is easy to elongate, whereas the core material is a straight structure that is easily subjected to a tensile force load). For this reason, a thick wire is used for the core material to increase the cross-sectional area and reduce the tensile stress applied to the core material, thereby preventing the core material from breaking early and improving the tensile breaking force as a rope. It is.
And if a core material and a side material are less than the wire diameter ratio 1.0 of the same wire diameter, the load of the tensile force added to a core material will increase, and the tensile fracture force of the rope by the early fracture | rupture of a core material will be reduced. Moreover, if it exceeds the said upper limit (wire diameter ratio 2.12), the rigidity of a core material will increase and a repeated bending fatigue-proof characteristic will be inferior. Note that the wire diameter ratio of Examples A to C is 1.18.
Therefore, the wire diameter ratio (core material / side material) is preferably 1.0 times to 2.12 times, more preferably 1.07 times to 2.12 times, and still more preferably 1.18 times to 2. .12 times.

Next, a strand rope will be described as another embodiment of the operation rope 20. The strand rope here means a rope in which three or more strands are twisted together, and is called (m × n), where m is the total number of strands and n is the number of metal strands in the strand. . For example, as an example of another strand rope, when the total number of strands is 7 bundles using the spiral rope twist configuration 1 × 7 of Example A, 7 × 7 (illustration (F)), similarly When the total number of strands is 7 bundles using the twist configuration 1 × 8 of Example D of the spiral rope, it becomes 7 × 8 (not shown).
About the Example of the rope 20 for operation of this invention, both the said spiral rope and a strand rope are included, and the metal strand to be used is the same as that of each said Example AC.
The spiral rope is used when the medical treatment instrument is inserted into the body with relatively little meandering and requires a high tensile force, and is particularly suitable when a push operation force and a rotation operation force are required. On the other hand, the strand rope is used when there is a large amount of bending meandering, a light operating force and a high bending stress resistance, and is particularly suitable when a repeated bending fatigue resistance characteristic is required. Which one to select is determined by the relationship between the degree of bending meandering and the required operability.

In addition, if supplemented, even if the joining member 21 having a melting temperature matched with the temperature range of the low-temperature heat treatment for increasing the tensile breaking strength of the metal wire is used, the tensile breaking force of the operating rope 20 is improved and the joining is performed. It is possible to improve mechanical strength characteristics such as fatigue resistance characteristics of the rope for operation at the section. Specifically, for example, in FIG. 3, the distal end portion 20a of the operation rope 20 and the connecting member 22a of the distal end rope receiver of the distal bending piece 18a are joined by melting and heating the joining member 21.
The joining member 21 uses a eutectic alloy having a melting temperature of 180 ° C. to 495 ° C., or an eutectic alloy having a melting point of 180 ° C. to 525 ° C. when the metal wire of the operation rope 20 is an austenitic stainless steel wire containing Mo. . The eutectic alloy here refers to a special alloy having the lowest melting point (melting temperature) obtained by changing the component ratio of the alloy, and specifically, an alloy material containing gold or silver. 80% by weight of gold as a tin-based alloy material, the balance being tin and a melting temperature of 280 ° C., and 3.5% by weight of silver as a tin-based alloy, the balance being tin and a melting temperature of 221 ° C., and 88% by weight of gold, The balance is germanium, which is a eutectic alloy having a melting temperature of 356 ° C., silver, tin, and indium, and having a melting temperature of 450 ° C. to 472 ° C. Typical examples are shown in Table 5.

  The reason why gold is used as the joining member 21 is to improve corrosion resistance and spreadability, the reason why silver is used is to adjust the melting point, and the reason why tin is used is to reduce the melting point and to operate the rope. This is to improve the wettability with 20.

  The reason why the melting temperature of the joining member 21 is 180 ° C. to 495 ° C., or 180 ° C. to 525 ° C. is that the tensile breaking force of the work rope 20 that has been work-hardened when the temperature falls below 180 ° C. When the temperature exceeds 495 ° C., the characteristics of the austenitic stainless steel wire of the metal strand used for the operation rope 20, or when it exceeds 525 ° C., the austenitic stainless steel wire containing Mo Due to the nature, when each austenitic stainless steel wire is heated to 520 ° C. or 800 ° C. exceeding 540 ° C., a sensitization phenomenon occurs, and as described later, the tensile fracture strength characteristics are extremely lowered, and this phenomenon This is because the mechanical strength characteristics of the operating rope 20 are maximized.

The tensile breaking strength of the distal end portion 20a of the operating rope 20 at the joint portion with the connecting member 22a of the distal end rope receiver is increased by the melting heat of the joining member 21, and the tensile stress increases with the increase in the tensile breaking strength. As a result, the bending fatigue resistance of the operating rope at the joint is improved.
Thus, there is no risk that the operation rope 20 and the connecting member 22a of the tip rope receiver are detached due to repeated bending fatigue applied to the joint portion of the tip portion 20a of the operation rope 20 during the operation of the surgeon. In addition, if a silver solder having a melting temperature of 605 ° C. to 800 ° C. and a gold solder having a melting temperature of 895 ° C. to 1030 ° C. are used, as described above, the core material or the side material may be sensitized. The brittle or annealed state significantly reduces the tensile breaking strength, and the lower end of the tensile breaking strength and bending stress causes the distal end portion 20a of the operating rope 20 to move away from the connecting member 22a of the distal end rope receiver. There is a risk that the risk of falling off increases, the bending operation knob 3 becomes inoperable, and the medical endoscope becomes inoperable.

If further supplemented, the tip portion 20a of the operation rope 20 has a predetermined length along the length of the connecting member 22a of the tip rope receiver, for example, the length of the connecting member 22a of the tip rope receiver. If the length is 2 mm, it is desirable to perform electrolytic polishing about 2 mm to 100 mm. Or you may grind with sandpaper etc.
The reason for polishing the distal end portion 20a of the operation rope 20 before melting the eutectic alloy of the joining member 21 is that the metal wire that has been drawn (particularly the area reduction ratio is 90% or more) in strong working is particularly important. The rope for operation that is twisted and configured to be used has an extremely poor wettability with the joining member 21. In order to prevent this, the oxide film is removed by electrolytic polishing or the like to improve the wettability. This is to improve the bondability by 21. Moreover, you may use the rope 20 for operation which gave electrolytic polishing etc. over the full length beforehand. In addition, if we supplement, the reason why the wettability with the joining member 21 of the operating rope is extremely deteriorated is that the fibrous structure of the surface portion of the metal strand that appears as the degree of processing of the strong wire drawing increases. This can be attributed to the development and formation of an oxide film.

Further, the portion of the distal end portion 20a of the operation rope 20 has a predetermined length along the longitudinal length of the connecting member 22a of the distal end rope receiver, for example, the longitudinal length of the connecting member 22a of the distal end rope receiver. If it is 2 mm, a plating process of about 1 mm to 10 mm, or a bonding member 211 may be impregnated in the gap between the core material and the side material and fixed to the outer periphery of the side material, and then the bonding member 21 may be melted and fixed. Good. In such a case, it is desirable to use a material containing the same composition component as the eutectic alloy of the joining member 21 as the material used for the plating process. For example, if the joining member 21 contains a component containing gold or silver The material to be plated is preferably gold plating or silver plating.
Then, the tip portion 20a of the operation rope 20 may be impregnated and fixed in advance, and the joining member 211 used in this case is preferably the same or the same type of eutectic alloy as the joining member 21. In addition, the joining member which is the eutectic alloy of the same kind here means that the total weight% of one or two identical composition components is 50% by weight or more of the whole. And A2 are the same, or A1 and B1 are different.

This structure has the following specific effects. In other words, the joint strength between the distal end portion 20a of the operating rope 20 and the connecting member 22a of the distal end rope receiver is strengthened, and the joint strength is increased by the fusion-integrated fixation at the joint portion between the joint member 211 and the joint member 21. It can be greatly improved.
The reason why the distal end portion 20a of the operation rope 20 is plated or impregnated and fixed with the joining member 211 in advance is that the joining member 21 of the operation rope 20 whose wettability is extremely deteriorated by the wire drawing of the strong working. This is for improving the wettability and enabling a strong bond. When the joining member 211 is melted and fixed in advance, the joining member 211 is inserted through the connecting member 22a of the tip rope receiver, and then the welding member 211 is irradiated with a laser beam to remelt the joining member 211 to remelt the tip rope receiver. The connecting member 22a may be joined. In such a case, the joining member 211 needs to be formed thick on the surface of the distal end portion 20a of the operation rope 20 to such an extent that the valleys of the twisted strands cannot be seen, and each operation rope 20 of the present invention is implemented. It is desirable to use the same or the same kind of eutectic alloy as the joining member 21 used in the example. Thereby, the assembly | attachment operation | work of joining with the connection member 22a of the tip rope receiver and the tip part 20a of the operation rope 20 in a joining process can be simplified.

  Next, the structure of the connecting member 22a of the distal end rope receiver of the operating rope 20 is fixed to the inner peripheral side distal end portion of the distal bending piece 18a by using the connecting member 221 of the tubular rope receiver of the short tubular body. After inserting the tip 20a of the rope 20 for use, the joining member 21 may be used for joining. In this case, from the viewpoint of improving the bonding strength, the connecting member 22a of the distal end rope receiver of the distal bending piece 18a or the connecting member 221 of the tubular rope receiver is formed of the same or the same material as the operation rope 20. More desirable. Here, the same kind of material refers to the same kind of material as long as the prefix is the same steel material regardless of any of the steel type symbols in the JIS display (regardless of either austenitic SUS304 or martensitic SUS403). Say. Therefore, the stainless steel material and the aluminum steel material are different materials. Most preferred is the same material.

  Next, other examples 2 to 7 of the medical treatment tool of the present invention will be described below.

FIG. 8 shows the medical endoscope high-frequency snare 13A of the second embodiment which is the medical endoscope treatment tool of the present invention. FIG. 8A shows the distal treatment section 17, which is connected to the hand operation section 2. The connecting member 221 of the tubular rope receiver joins the treatment loop 17A and the distal end portion of the operating rope 20 to the distal end portion of the operating rope 20 using the joining member 21 at the tubular body or the tubular body end portion. Has been.
The figure (B) shows the hand operation part 2, and the hand operation part 2 is flat plate shape which has the terminal 30 connected to the operation part main body 2A provided with the guide groove 2D and the finger ring 2C, and the high frequency generator (not shown). The connecting member 222 has a hole portion 32 into which the proximal end of the operation rope 20 is inserted, and the proximal portion of the operation rope 20 is inserted into the hole portion 32. The operation rope 20 is joined to the hole 32 using the joining member 21. A reinforcing pipe 2E is provided outside the hand portion of the operation rope 20 to prevent buckling, and is connected to the slider 2B. In addition, illustration (C) (D) shows the partially expanded view of the rope 20 for operation of the front treatment part 17, and the connection member 221, and illustration (E) and (F) are for operation of the hand operation part 2. A partially enlarged view of the rope 20 and the connecting member 222 is shown.

  Then, by moving the slider 2B in the front-rear direction (the left-right direction in the drawing) along the guide groove 2D, an operation force is applied to the operation rope 20 connected to the slider 2B, and the treatment loop 17A is insulated with a fluorine resin or the like. It is housed in a sheath 241 made of material (slider 2B is moved to the right side in the figure) or is expanded outside the sheath 241 (slider 2B is moved to the left side in the figure), and the affected part is supplemented by the treatment loop 17A. The terminal 30 is connected to the high-frequency device, and the connection member 222, the operation rope 20, the connection member 221, and the treatment loop 17A are energized to remove the affected area and perform treatment such as hemostasis.

The operation rope 20 and the connecting members 221 and 222 are joined to each other inside the connecting members 221 and 222 using the joining member 21 or at the end.
In this configuration, the operating rope 20 of the present invention is a metal having a high strength tensile fracture strength by repeating one or more sets of wire drawing and low-temperature heat treatment of strong working using a solidified austenitic stainless steel wire. The tensile breaking force of the operating rope 20 is increased by forming the strands in a twisted configuration and applying a low-temperature heat treatment for a short time after the twisted configuration.

Thereby, the bending fatigue resistance characteristic and wear resistance characteristic of the rope 20 for operation can be improved. The reason why the bending fatigue resistance is improved is that the bending fatigue resistance increases when the combined stress of the tensile stress and bending stress is higher when the tensile force is applied. This is because the tensile stress increases due to the increase in the tension or the tensile breaking force of the operating rope, and the resultant stress increases. The reason why the wear resistance is improved is that the hardness of the metal strand increases as the tensile break strength of the metal strand increases or the tensile fracture strength of the operation rope increases. Specifically, the bending piece 18 that is slid with the connecting members 221 and 222 made of stainless steel, which is a member in contact with the operating rope, the connecting member 22a of the first embodiment, and the operating rope 20 due to bending deformation. This is because it is about three times higher than the hardness of the rope receiver 22 or the like (Vickers hardness of 150 to 200).
The operation rope 20 of the present invention also exhibits the same effect as described above even when used in the treatment loop 17A that expands and contracts the distal treatment portion 17.

  And supplementally, the joining member 21 is simply fixed by using the joining member 21 having a melting temperature that matches the temperature range of the low-temperature heat treatment for increasing the tensile breaking force of the metal strand and the twisted rope. Instead of using as a means, it is possible to improve the joint strength of the joint while improving the tensile breaking force of the operation rope 20 at the joint.

  If further supplemented, the reduction in the wettability of the joining member 21 due to the strong wire drawing, the improvement in the joining property by performing treatment such as electrolytic polishing on at least the joining portion of the operation rope, and the connecting member 221, By using a stainless steel material for 222, the same or the same kind of material as the rope for operation is used to reduce the difference in thermal expansion between them, and equalize the wettability with the joining member, thereby firmly joining the joining member. It is possible to improve the performance. The difference from the medical endoscope snare 13 (Example 3) is mainly the presence / absence of the terminal 30 connected to the high-frequency device, the presence / absence of insulation (for example, the material of the sheath 241), and the like.

  FIG. 9 shows the medical endoscope forceps 14 of Example 4 which is the medical endoscope treatment tool of the present invention. FIG. 9A shows the distal treatment section 17, which is connected to the hand operation section 2. The distal end of the operating rope 20 is connected to a biopsy forceps 17B composed of a pantograph mechanism at the distal end thereof, and has a flattened connection pin hole 221Z (illustration (C)). The substantially cylindrical connecting member 221 </ b> A is joined to the distal end portion of the operation rope 20 in the substantially cylindrical cylinder or the cylindrical end portion using the joining member 21. The figure (B) shows the hand operation part 2, and the hand operation part 2 is connected to the operation part main body 2A provided with the guide groove 2D and the finger ring 2C, and the substantially cylindrical connection connected to the hand part of the operation rope 20. The substantially cylindrical connecting member 222A is composed of the slider 2B provided with the member 222A, and is joined to the proximal portion of the operation rope 20 with the joining member 21 in the substantially cylindrical cylinder or at the cylindrical end portion. . A reinforcing pipe 2E is provided outside the hand portion of the operation rope 20 to prevent buckling, and is connected to the slider 2B. In addition, illustration (C) (D) shows the partially expanded view of the rope 20 for operation of the front-end | tip treatment part 17, and connection member 221A, and illustration (E) and (F) are for operation of the hand operation part 2. The partially expanded view of the rope 20 and the connection member 222A is shown.

  Then, by moving the slider 2B in the front-rear direction (the left-right direction in the drawing) along the guide groove 2D, an operation force is applied to the operation rope 20 connected to the slider 2B, and the forceps cup of the biopsy forceps 17B is opened ( The slider 2B is moved to the left side in the figure) and closed (the slider 2B is moved to the right side in the figure) to supplement the affected part and perform treatment such as excision. The difference between the forceps 14 for medical endoscope (Example 4) and the hot biopsy forceps 14A for medical endoscope (Example 5), which is a medical treatment instrument using high-frequency energization, is the same as in Examples 2 and 3 described above. In the same manner as in Example 5, in the case of Example 5, the terminal 30 similar to that of Example 2 above is determined by the presence or absence of the terminal 30 to be joined to the high-frequency device and the presence or absence of insulation (for example, the material of the sheaths 241 and 242). For example, the terminal is connected to the connecting member 222A in the slider 2B. (See FIGS. 8E and 8F)

According to this configuration, Examples 4 to 5 obtain the operation rope 20 in which the metal strands having high strength tensile breaking strength characteristics by the strong wire drawing work are twisted as in Examples 1 to 3 described above. Thus, the opening / closing operation of the forceps cup of the biopsy forceps 17B can be facilitated to improve the excision treatment, and the hand operating section 2 can be made compact. The reason for this is that the cutting operation becomes easier due to the increase in the tensile breaking force of the operating rope, the elongation of the rope decreases with the increase in the tensile breaking force, and the moving distance of the slider 2B of the hand operating section 2 is reduced. This is because the responsiveness to the distal treatment section is improved and the size of the slider 2B can be reduced by reducing the moving distance.
And if it supplements, it is for operation of a junction part using the fusion | melting heat of the joining member 21 which has a melting temperature corresponding to the temperature range of the low temperature heat processing which increases the tensile breaking force of the metal strand and the rope comprised by twisting. Providing a treatment instrument for a medical endoscope that can be joined by further increasing the tensile breaking force of the rope 20 and that has a high degree of operability in addition to the high conductivity characteristics of a joining member containing a gold or silver component. Can do.

  Next, FIG. 10 shows the medical endoscope clip device 15 of Example 6 which is the medical endoscope treatment tool of the present invention, and the clip 17C of the distal treatment section 17 is housed in the introduction tube 33. Then, the operating rope joined to the connecting member 222B in the slider 2B and the joining member 21 by moving the slider 2B of the hand operating part 2 to the right in the figure along the guide groove 2D. 20, an operating force is applied, and the force is transmitted to the hook-shaped connecting member 221B joined to the distal end portion of the operating rope by the joining member 21, and the clip 17C is detached from the hook-shaped connecting member 221B and detached, and the affected part is removed. Capturing and closing the blood vessel for hemostasis treatment. Incidentally, FIG. (C) is a longitudinal sectional view showing a clip state of the blood vessel 34 by the clip 17C.

Next, FIG. 11 shows the medical endoscope high-frequency knife 16 of Example 7 which is the medical endoscope treatment tool of the present invention, and the knife portion 17D of the distal treatment section 17 is inserted into the body to the affected area. After approaching, the slider portion 2B of the hand operation portion 2 is moved in the left direction in the figure along the guide groove 2D, so that the connecting member 222C having the terminal 30 that can be connected to the high frequency device in the slider 2B and the joining member 21 are joined. An operating force is applied to the operating rope 20 that is being operated.
A force is applied to the substantially cylindrical connecting member 221C joined to the distal end portion of the operating rope 20 by the joining member 21, and the rod-like electrode portion 172D and the flat electrode portion 171D joined to the distal end side of the connecting member 221C The plate-like electrode portion 171D of the knife portion 17D made of the above is brought into contact with the affected area to treat the living tissue for cautery incision. Note that the medical treatment instrument of the seventh embodiment has a function of causing the physiological saline to pass through the internal space 243A of the sheath 243 from the syringe 31 and ejecting from the distal treatment section 17 to clarify the bleeding part.
And in Example 6, 7, the joining method of the rope 20 for operation and connection member 221B, 222B, 221C, 222C using the joining member 21 is the same as that of the said Examples 1-5.

By this structure, Example 6, 7 obtains the operation rope 20 which twisted and comprised the metal strand which has the high strength tensile breaking strength characteristic by the strong wire drawing like the said Examples 1-5. Thus, it is possible to cope with an increase in operating force applied to the rope by increasing the number of clips connected, and as a result, a plurality of locations can be obtained by a single insertion operation from the treatment tool hole into the medical endoscope of the assembly described later. Clip placement can be enabled. Further, by using an operation rope having an improved tensile breaking force, it is possible to facilitate the treatment of cautery incision of living tissue. The reason for this is that the operating temperature range used for cauterization hemostasis by applying a high-frequency current is generally within the temperature range where the tensile strength at break of the metal strand used for the operating rope is increased from 180 ° C to 350 ° C. Because.
And if it supplements, it uses the fusion | melting heat of the joining member 21 which has the melting temperature corresponding to the temperature range of the low-temperature heat processing which increases the tensile breaking force of the rope for operation like the said Examples 1-5, and uses a fusion | melting part. A treatment instrument for a medical endoscope having a high degree of operability, which can be joined by improving the tensile breaking force of the rope 20 for operation, and in addition to the high conductivity characteristics of a joining member containing a gold or silver component. Can be provided.

  In addition, in a medical treatment instrument using physiological saline, when a joint member containing a silver component is used, silver sulfide or the like is formed by contact with physiological saline, and blackening starts. As the process progresses, the blackening progresses further, the corrosion progresses, and the bonding strength decreases. For this reason, it is a more desirable joining form to use the joining member 21 of a gold eutectic alloy from the viewpoint of preventing the joining strength from being lowered due to the progress of corrosion and preventing blackening. This is because the physiological saline is passed through the inner hole of the channel tube of the medical endoscope, and the objective lens at the tip is washed, and the physiological saline is applied to the lesion to clarify the lesion. The same problem also occurs when spraying, which is a technical problem common to medical endoscopes and medical endoscope treatment tools. By this method, this technical problem can be solved.

In particular, in Examples 6 and 7, the operating rope 20 of the present invention that can easily control the clip 17C or the knife portion 17D of the distal treatment section 17 to a desired affected area position by pushing and rotating the hand operating section. A spiral rope is more preferable than a strand rope, and more preferable is a mode in which the core material uses a large-diameter wire in a certain range rather than the side material in the spiral rope as described above.
The reason for this is that the pushing operation and rotating operation of the hand operating part are greatly influenced by the characteristics of the rope for operation, particularly the straight core material. The larger the core wire diameter is, the larger this value is, so that the buckling resistance is improved and the pushing operation force is improved. In addition, in the case of rotational operation, the torsional resistance moment is proportional to the cross-sectional secondary pole moment, and this value increases as the wire diameter increases, and as a result, the ability to transmit rotation to the tip can be improved. Because.

Next, a method for manufacturing the medical treatment tool of the present invention will be described below.
A distal treatment section is provided on the distal end side of the flexible tubular body, and a proximal operation section is provided on the proximal side, and an operation rope inserted through the flexible tubular body is connected to the distal treatment section and the proximal operation section. In the method of manufacturing a medical treatment instrument that operates the distal treatment section by transmitting the operation force of the operation rope by pushing, pulling, or rotating the hand operation section,
The metal wire used for the operation rope is a solidified austenitic stainless steel wire, and is provided with a wire drawing step and a low temperature heat treatment step at 180 to 495 ° C. for 10 to 180 minutes after the wire drawing step. And
Alternatively, when the metal strand is an austenitic stainless steel wire containing Mo, a low-temperature heat treatment step of 180 ° C. to 525 ° C. is provided,
After the wire drawing step and the low-temperature heat treatment step are set as one set and at least one set of each step is repeated, a final wire drawing step is provided,
The total area reduction until the final wire drawing step is 95% to 99.5% or less,
The total increase rate of the tensile breaking strength by the low-temperature heat treatment until the final wire drawing step was 10% or more, and Y: tensile breaking strength (kgf / mm 2) and X: total area reduction rate (%). In case,
Satisfies the relational expression of Y ≧ 2.000X + 70,
The operating rope is a method for manufacturing a medical treatment instrument, comprising a step of twisting a plurality of metal strands having a strand diameter of 0.008 mm to 0.200 mm.
With this configuration, a low-temperature heat treatment process is provided in a temperature range where the tensile breaking strength of the drawn metal wire steeply increases, a high-strength wire drawing process and a low-temperature heat treatment process are provided, or these By accumulating processes, a metal treatment wire having a high strength tensile breaking strength can be twisted to manufacture a medical treatment instrument including an operation rope having a high strength tensile breaking strength.
And if supplemented, even if the heat of fusion of the joining member having a melting temperature that matches the temperature range of the low-temperature heat treatment in the temperature range where the tensile breaking strength steeply increases, the tensile breaking force of the operating rope can be reduced. It is possible to manufacture a medical treatment instrument that can be joined by increasing the number.

In the method for manufacturing a medical treatment instrument described above, the step of “at least one set including the wire drawing step and the low temperature heat treatment step as a set” is a primary wire drawing with a reduction in area of 80% to 94%. And a primary low-temperature heat treatment step at 180 to 495 ° C. for 10 to 180 minutes, or when the metal strand is an austenitic stainless steel wire containing Mo, then a primary low-temperature at 180 to 525 ° C. A heat treatment step is provided, and the rate of increase in tensile breaking strength by the primary low-temperature heat treatment is 6% or more,
A secondary wire drawing step with a reduction in area of 40% to 79% and a secondary low-temperature heat treatment step at 180 ° C. to 495 ° C. for 10 minutes to 180 minutes, or an austenitic system in which the metal strand contains Mo In the case of a stainless steel wire, a secondary low-temperature heat treatment step is subsequently performed at 180 to 525 ° C. for 10 to 180 minutes, and the rate of increase in tensile fracture strength due to the secondary low-temperature heat treatment is 4% or more. It is a manufacturing method of the medical treatment tool characterized by the above-mentioned.
With this configuration, a high strength tensile rupture strength can be obtained by using a commercially available austenitic stainless steel wire without using an expensive metal material having a complicated metal structure (for example, a high silicon stainless steel wire). Metal wire can be manufactured, the area reduction ratio of the primary wire drawing process can be maximized, the production of work-induced martensite contributing to the effect of improving the tensile breaking strength can be further increased, and the tensile breaking strength can be increased. By providing a low-temperature heat treatment step in a temperature range where the steep slope increases and accumulating the wire drawing step and the low-temperature heat treatment step, it is possible to manufacture a metal strand whose tensile fracture strength has been dramatically increased.

In the manufacturing method of each medical treatment instrument described above, the area reduction rate is 4% to 20% in each wire drawing step from the primary wire drawing step to the final wire drawing step used in the operation rope. In the step of continuously drawing using a plurality of dies, and in the final drawing step, continuous drawing is performed using a plurality of dies having a surface reduction rate of 4% to 20%, and the surface reduction rate of the final die Is a continuous wire drawing process of a die arrangement having the smallest area reduction rate in the final wire drawing step of 4% to 13%, and the wire drawing step comprises a wet wire drawing step. It is a manufacturing method of a medical treatment tool.
With this configuration, even if the wire diameter of the metal wire is an ultrathin wire of 0.100 mm or less, the wire can be continuously drawn without breaking the metal wire having a high tensile breaking strength, and the productivity It is possible to manufacture an operation rope made of a metal wire having a high quality and a stable quality.

And in order to obtain the metal strand which has the high strength tensile breaking strength by such a strong wire drawing process, in the final wire drawing process, a plurality of dies (5 to 8), and among the multiple dies (5 to 8), the final die is a die that uses a die with the area reduction rate of 4% to 13% and the smallest area reduction rate in the final wire drawing process. An array.
And, in the die for wire drawing of such ultrafine wire, by using a diamond die, resistance at the time of wire drawing can be lowered to prevent disconnection in the wire drawing process, and productivity is high. In addition, a stable quality metal wire can be obtained.

  And to supplement, in order to further enhance the tensile breaking strength improvement effect due to the formation of work-induced martensite, the surface temperature of the metal wire during wire drawing is desirably 140 ° C. or less, and the setting of the cooling lubricating liquid in wet wire drawing Alternatively, this can be achieved by setting a lubricating liquid to be sprayed on the die during wire drawing and setting a temperature with these lubricating liquids. For example, the set temperature of the lubricating liquid in the case of wet wire drawing is desirably 28 ° C. to 42 ° C. in order to maintain the surface temperature of the metal strand.

Next, an assembly of the medical endoscope 1 having the treatment instrument hole 10 which is a medical treatment instrument and the medical endoscope treatment instrument according to the second to seventh embodiments will be described with reference to FIGS. .
In the assembly, a plurality of bending pieces 18 are connected to the distal treatment section 17, and the bending pieces 18a on the distal end side and the distal ends of the operation ropes 20 are joined using the joining members 21 and 211. 6, the bending portion 6 is bent and deformed by the operation of transmitting the operating force of the operating rope 20 by operating the hand operation portion 2, and the treatment tool hole 10 is provided in the hand operation portion 2. The medical endoscope 1 that is the medical treatment instrument described in 1) and the medical endoscope treatment instrument 1 of Examples 2 to 7 are moved in and out of the treatment instrument hole 10 to perform lesion treatment. This is an assembly of the medical endoscope 1 and the medical endoscope treatment tool.
This configuration prevents the interruption of the procedure when the medical endoscope and the treatment instrument for medical endoscope are inoperable due to insufficient tensile breaking force of the operating rope and insufficient tensile breaking force at the joint. Thus, it is possible to provide an assembly capable of handling various procedures for a lesioned part smoothly and quickly while having high operability. Further, the pushability of the medical endoscope treatment tool and the operability of the rotation operation are improved by using a metal wire having a diameter larger than that of the side material as the core material for the operation rope. Can do.

  In addition, by using a joining member having a melting temperature that matches the temperature range of the low-temperature heat treatment in the temperature range where the tensile breaking strength suddenly increases at the joining portion of the operation rope and the connecting member, Increases the tensile breaking force of the rope for operation at the site, improves the energization characteristics by using a highly energized bonding member that treats the affected area by energizing the high-frequency current, and further cleans or lesions the objective lens In order to prevent blackening at joints by allowing physiological saline to pass through the channel tube of a medical endoscope or the inner hole in the sheath of a medical endoscope treatment instrument for accurate recognition of the part, etc. An assembly having a high degree of operability can be provided by, for example, selecting and using a joining member containing any gold component.

And here, when the joining portion of the operating rope and the connecting member is joined using a eutectic alloy joining member having a melting temperature that matches the temperature range of the low temperature heat treatment, the melting heat of the joining member is utilized. It is possible to increase the tensile breaking force of the operation rope at the joint, thereby enabling a strong bond. A specific example of a medical treatment tool using the joining member will be described below.
Join the connecting member of the distal treatment section of the operating rope inserted through the flexible tube, or the connecting member of the hand operating section and the operating rope using the joining member, and press the hand operating section, In the medical treatment instrument for operating the distal treatment section by transmitting or operating the pulling or rotating operation force of the operating rope,
The operating rope is formed by twisting a plurality of metal strands having a strand diameter of 0.008 mm to 0.200 mm, and the metal strand uses a solution-treated austenitic stainless steel wire. Then, after drawing and drawing, provide low temperature heat treatment from 180 to 495 ° C,
Alternatively, when the metal strand is an austenitic stainless steel wire containing Mo, a low temperature heat treatment of 180 ° C. to 525 ° C. is provided,
The wire drawing and the low-temperature heat treatment are repeated as at least one set and the final wire drawing is performed, and the total area reduction until the final wire drawing is 95% to 99.5% or less,
The total increase rate of tensile breaking strength due to the low-temperature heat treatment until the final wire drawing is 10% or more, and
Y: Tensile breaking strength (kgf / mm2), X: Total area reduction rate (%)
Satisfies the relational expression of Y ≧ 2.000X + 70,
The joining member is made of a eutectic alloy having a melting temperature of 180 ° C. to 495 ° C., or when the metal strand is an austenitic stainless steel wire containing Mo, a eutectic having a melting temperature of 180 ° C. to 525 ° C. A medical treatment instrument made of an alloy, wherein the operation rope and the connecting member are joined using the joining member.

In addition, when the eutectic alloy joining member having a melting temperature that matches the temperature range of the low-temperature heat treatment is joined to the joining portion between the operation rope and the connecting member, joining is performed using the melting heat of the joining member. Accordingly, it is possible to manufacture a medical treatment instrument including an operation rope that can increase the tensile breaking force of the operation rope of the portion and enable a strong connection. The specific example of the manufacturing method is described below.
Join the connecting member of the distal treatment section of the operating rope inserted through the flexible tube, or the connecting member of the hand operating section and the operating rope using the joining member, and press the hand operating section, In the manufacturing method of the medical treatment tool for operating the distal treatment section by transmitting or operating the pulling or rotating operation force of the operating rope,
The metal wire used for the operation rope is a solidified austenitic stainless steel wire, and is provided with a wire drawing step and a low temperature heat treatment step at 180 to 495 ° C. for 10 to 180 minutes after the wire drawing step. Or when the metal strand is an austenitic stainless steel wire containing Mo, a low-temperature heat treatment step of 180 ° C. to 525 ° C. is provided,
The wire drawing step and the low-temperature heat treatment step are set as one set, and after at least one set of each step is repeated, a final wire drawing step is provided. % Or less,
The total increase rate of the tensile breaking strength by the low-temperature heat treatment until the final wire drawing step was 10% or more, and Y: tensile breaking strength (kgf / mm 2) and X: total area reduction rate (%). In case,
Satisfies the relational expression of Y ≧ 2.000X + 70,
The operation rope includes a step of twisting a plurality of the metal strands having a strand diameter of 0.008 mm to 0.200 mm,
A step of cutting a predetermined length after electropolishing the twisted rope; or a step of electropolishing after cutting the twisted rope a predetermined length;
Then, the step of inserting the distal end portion of the operating rope that has been cut into the hole portion of the connecting member of the distal end treatment portion, or the hand portion of the operating rope that has been cut thereafter to the hole portion of the connecting member of the hand operating portion. Inserting, and
The joint member made of a eutectic alloy having a melting temperature of 180 ° C. to 495 ° C. is melted at the joint portion with the operation rope inserted into the connecting member, or the metal strand of the operation rope is Mo In the case of an austenitic stainless steel wire containing, the joining member made of a eutectic alloy having a melting temperature of 180 ° C. to 525 ° C. is melted, and the connecting member and the operation rope are joined using the joining member. It is a manufacturing method of the medical treatment tool characterized by comprising a process.

In the method for manufacturing the medical treatment instrument described above, as a preferable aspect of the joining method using the joining member, “the joining member made of the same or the same kind of material as the joining member is melted and the operation rope” Is a method of manufacturing a medical treatment instrument characterized by comprising a step of bonding using a bonding member.
Thereby, the rope for operation and the connecting member are the same or use the same material, thereby reducing the difference in thermal expansion between them, and the wettability between the rope for operation and the connecting member, and the connecting member and the connecting member. Higher joint strength can be obtained by making the wettability of the joint substantially uniform on the joint surface and by making the joint force between the joint members of the joint part uniform.

[Effect of the invention]
As described above, the medical treatment tool of the present invention is a high-strength tensile wire by performing high-strength wire drawing and low-temperature heat treatment in a temperature range where the tensile breaking strength sharply increases, or by accumulating this. A metal strand having a breaking strength is obtained and twisted to form an operation rope having a high tensile breaking force and high operability.

  Further, using the medical endoscope of the present invention provided with a treatment tool hole, each medical endoscope treatment tool is moved in and out of the treatment tool hole, and a treatment corresponding to the condition of the lesioned part is performed. It is possible to provide a medical treatment instrument assembly having a high degree of operability to a person, and can greatly contribute to rapid treatment. There are the above various effects.

DESCRIPTION OF SYMBOLS 1 Medical endoscope 2 Operation part 3 Bending operation knob 4 Insertion part 5 Flexible tube part 6 Bending part 7 Tip structure part 10 Treatment tool hole 13 Snare 13A for medical endoscopes High frequency snare 14 for medical endoscopes Endoscopic forceps 14A Medical endoscope hot biopsy forceps 15 Medical endoscope clip device 16 High-frequency knife for medical endoscope 18 Bending piece 20 Operation rope 20a Operation rope tip 21 Joining member 22 Rope receiver 22a Connecting member 221 for the tip rope receiver Connecting member for the tubular rope receiver

Claims (9)

A flexible tube is provided with a distal treatment section on the distal end side and a proximal operation section on the proximal side, and an operation rope inserted through the flexible tubular body is connected to the distal treatment section and the proximal operation section. ,
In the medical treatment instrument that operates the distal treatment section by transmitting the operation force of the operation rope by pushing, pulling, or rotating the hand operation section,
The operation rope is formed by twisting a plurality of metal strands having a strand diameter of 0.008 mm to 0.200 mm,
The metal element wire is subjected to a solution treatment and using an austenitic stainless steel wire that does not contain Mo as a component, and after the wire drawing and wire drawing, a low-temperature heat treatment at 180 ° C. to 495 ° C. is provided, or the metal The element wire is subjected to a solution treatment, and using an austenitic stainless steel wire containing Mo as a component, a low-temperature heat treatment of 180 ° C. to 525 ° C. is performed after drawing and drawing ,
After drawing the wire drawing and the low temperature heat treatment as one set and repeating at least one set, the final wire drawing is performed,
The total area reduction until the final wire drawing is 95% to 99.5% or less,
When the total increase rate of tensile breaking strength by the low-temperature heat treatment until the final wire drawing is 10% or more, and Y: tensile breaking strength (kgf / mm 2), X: total area reduction rate (%) Satisfies the relational expression of Y ≧ 2.000X + 70,
A medical treatment instrument comprising an operation rope using the metal strand. The medical treatment tool according to claim 1, wherein
With one set of wire drawing and low-temperature heat treatment of the metal wire of the operation rope as one set, the area reduction rate of the primary wire drawing is 80% to 94%,
When the metal strand is an austenitic stainless steel wire that does not contain Mo in its component, a primary low-temperature heat treatment is performed after the primary wire drawing at 180 ° C. to 495 ° C., or the metal strand has Mo as its component. When the austenitic stainless steel wire contains, after the primary wire drawing , a primary low-temperature heat treatment at 180 ° C. to 525 ° C. is provided,
The rate of increase in tensile breaking strength by the primary low-temperature heat treatment is 6% or more,
The area reduction rate of secondary wire drawing was changed from 40% to 79%,
When the metal strand is an austenitic stainless steel wire that does not contain Mo in its component, a secondary low-temperature heat treatment of 180 ° C. to 495 ° C. is provided after the secondary wire drawing , or the metal strand has its component In the case of an austenitic stainless steel wire containing Mo, a secondary low-temperature heat treatment from 180 ° C. to 525 ° C. is provided after the secondary wire drawing ,
A medical treatment instrument comprising an operation rope using the metal element wire, wherein the rate of increase in tensile breaking strength by the secondary low-temperature heat treatment is 4% or more. In the rope for operation composed by twisting using a plurality of the metal strands,
After a twist configuration, a short time low temperature heat treatment is provided,
The medical treatment instrument according to claim 1 or 2 , comprising an operation rope using the metal element wire, wherein the tensile strength is increased more than the tensile breaking force before the short-time low-temperature heat treatment. The operation rope is a spiral rope having a twisted configuration in which the metal strand is used as a core material and a side material, and 6 to 9 side materials are wound and formed in a one-way spiral around the outer periphery of the core material. Consisting of
The wire diameter of the core material is 1.07 to 2.12 times the wire diameter of the side material,
The medical treatment tool according to any one of claims 1 to 3 , wherein the medical treatment tool comprises an operation rope using the metal element wire. The medical treatment tool according to any one of claims 1 to 4 , wherein a plurality of bending pieces are connected to the distal treatment section, and the bending piece on the distal end side and the distal end portion of the operation rope are connected. A medical treatment instrument comprising a bending portion and a medical endoscope in which the bending portion is bent and deformed by operating the hand operation portion and transmitting an operation force of the operation rope. The medical treatment tool according to any one of claims 1 to 4 , wherein the distal operation unit is pushed, pulled, or rotated to transmit the operation force of the operation rope. A medical endoscope snare of a medical endoscope treatment tool for enlarging or contracting a treatment loop and then excising an affected area by energizing a high-frequency current to the operation rope and the distal treatment section, or A medical treatment instrument characterized by being a high-frequency snare for a medical endoscope. The medical treatment tool according to any one of claims 1 to 4 , wherein the distal operation unit is pushed, pulled, or rotated to transmit the operation force of the operation rope. A medical endoscope that opens and closes a forceps cup of a biopsy forceps and collects a living tissue, or opens and closes the forceps cup, and then excises the affected part by energizing a high-frequency current to the operation rope and the forceps cup. A medical treatment instrument characterized by being a medical endoscopic forceps for a medical treatment instrument or a hot biopsy forceps for a medical endoscope. The medical treatment tool according to any one of claims 1 to 4 , wherein the distal operation unit is pushed, pulled, or rotated to transmit the operation force of the operation rope. A medical treatment instrument characterized by being a medical endoscope clip device for a medical endoscope treatment instrument in which a clip is detached and placed in the body. The medical treatment tool according to any one of claims 1 to 4 , wherein the distal operation unit is pushed, pulled, or rotated to transmit the operation force of the operation rope. A high-frequency knife for a medical endoscope of a treatment instrument for medical endoscope that cauterizes and incises an affected living body tissue by applying a high-frequency current to the knife portion while guiding the knife portion to a desired position. A medical treatment instrument characterized by that.