JP5506556B2 - Medical devices and systems - Google Patents

Description

  The present invention relates to a medical device and a medical system that perform excision of a site in an airway of a human body.

  As a treatment method for, for example, a pharynx or a laryngeal lesion in a human airway, a method is also known in which treatment is performed using a treatment tool inserted from the oral cavity under observation of an endoscope inserted from the oral cavity.

  Further, as a method of excising a lesion near the tissue surface in the human body, as disclosed in, for example, Japanese Patent Application Laid-Open No. 2005-27722, a loop-like shape protruding from the endoscope and the distal end portion of the endoscope A method using a high-frequency snare is known.

JP-A-2005-27722

  The excision method using an endoscope and a high-frequency snare as disclosed in JP-A-2005-27722 does not require laparotomy, can suppress bleeding, and is performed in a relatively short time. Is possible.

  However, when the resection method using an endoscope and a high-frequency snare is applied to a procedure for resecting a lesion such as a pharynx or a larynx, it is easy to use a high-frequency snare because the airway is narrow. As described above, it is difficult to curve the endoscope distal end portion so as to be substantially perpendicular to the airway inner wall.

  The present invention has been made in view of the above problems, and provides a medical device and a medical system that can quickly and easily perform excision of a portion in the airway of a human body.

The medical device of the present invention includes an insertion portion that can be inserted into the airway from the oral cavity, a rotation portion that is provided at a distal end portion of the insertion portion, and that can rotate around an insertion axis of the insertion portion, and the rotation portion. A recess opening in a direction inclined with respect to the rotation axis, a suction conduit for sucking the inside of the recess connected in the recess, and a biological mucous membrane opening in the tip and existing in the recess A treatment instrument insertion conduit capable of projecting a treatment instrument for cutting out, and the recess is configured by a plurality of the cylindrical portions that are coaxially arranged and relatively movable in the axial direction, The opening shape of the concave portion is determined by the opening shape of the cylindrical portion located at the foremost end of the plurality of cylindrical portions . Moreover, the medical system of this invention is provided with the said medical device.

  ADVANTAGE OF THE INVENTION According to this invention, the excision treatment of the site | part in the airway of a human body can be performed quickly and easily.

It is a figure explaining a medical system. It is a side view explaining the whole structure of a medical device. It is a perspective view of the front-end | tip part of an insertion part. It is sectional drawing of the front-end | tip part of an insertion part. It is a fragmentary sectional view of an operation part. It is a perspective view which shows the mode of rotation of the rotation part of a front-end | tip part. It is a perspective view which shows operation | movement of the treatment tool which protrudes from a front-end | tip part. It is a figure explaining the usage pattern of a medical device. It is a figure explaining operation | movement of a medical device. It is a figure explaining operation | movement of a medical device. It is sectional drawing explaining the structure of the rotation part in a 1st modification. It is sectional drawing explaining the 2nd modification. It is sectional drawing explaining the 2nd modification.

  Hereinafter, preferred embodiments of the present invention will be described with reference to the drawings. In each drawing used for the following description, the scale is different for each component in order to make each component large enough to be recognized on the drawing. It is not limited only to the quantity of the component described in the figure, the shape of the component, the ratio of the size of the component, and the relative positional relationship of each component.

  The medical system 1 according to the present embodiment is for performing a treatment for excising a living tissue such as a lesioned part in the vicinity of a pharyngeal larynx of a human body, and is used for treatment of superficial pharyngeal cancer as an example. As shown in FIG. 1, the medical system 1 includes an endoscope 3 and a medical device 10. In general, the medical system 1 uses a medical device 10 inserted into the airway from the oral cavity while observing with the endoscope 3 inserted into the airway from the oral cavity of the human body. Configured to do. In addition, the medical system 1 includes a laryngoscope 2 that raises the tongue and lower jaw in order to quickly insert the endoscope 3 and the medical device 10 into the airway.

  The endoscope 3 includes an insertion portion 4 that can be introduced into a human body, and an observation portion (not shown) provided at a distal end portion 5 of the insertion portion 4. The observation unit is for capturing an optical image, and includes an imaging device including an objective lens and an imaging element such as a CCD disposed in the distal end portion 5 of the insertion unit 4, for example. . Since the endoscope 3 of this embodiment has the same configuration as a known endoscope, detailed description thereof will be omitted.

  The observation unit connects the objective lens disposed at the distal end portion 5 of the insertion portion 4, the eyepiece lens disposed at a site outside the human body of the endoscope 3, and the objective lens and the eyepiece lens. And an optical fiber cable configured to be configured. Further, the endoscope 3 may include a lighting device that illuminates the field of view of the observation unit.

  Below, the structure of the medical device 10 is demonstrated. As shown in FIG. 2, the medical device 10 includes an insertion portion 11 that can be inserted from the oral cavity into the airway, and an operation portion 40 that is disposed on the proximal end side of the insertion portion 11. ing. The medical device 10 is configured to be able to project a treatment tool for excising a living tissue from the insertion portion 11. The medical device 10 has a handpiece-like form in which a user performs excision of an affected area such as a superficial laryngeal cancer using a treatment tool while holding the operation unit 40.

  In the present embodiment, as an example, the medical device 10 is configured such that a high-frequency snare 60 as a treatment tool can protrude from the distal end portion 14 of the insertion portion 11. The high-frequency snare 60 includes a conductive wire having a loop portion 61 formed in an annular shape at the tip. The loop unit 61 is electrically connected to the power supply device 100 via the A cord 102.

  The power supply device 100 is a device that outputs a high-frequency current to the A cord 102 in accordance with the operation of the foot switch 101. Further, the power supply device 100 is electrically connected to the vicinity of the affected part of the human body to be treated through the P cord 103 and a counter electrode plate (not shown). The high-frequency snare 60 is a treatment tool for excising a living tissue by energizing a high-frequency current in a state where the living tissue is strangled by the loop unit 61. Since the high-frequency snare 60 has the same configuration as a well-known one, a detailed description thereof will be omitted.

  First, the structure of the insertion part 11 is demonstrated. The insertion portion 11 of the medical device 10 includes three portions, which are a rigid portion 12, a bending portion 13, and a distal end portion 14, which are sequentially arranged from the proximal end side. The hard part 12 is made of a hard substantially cylindrical member. The bending portion 13 is a substantially cylindrical member, which is bent by applying a predetermined force in the bending direction, and can hold the curved shape even after the force in the bending direction is removed. It is configured.

  As shown in FIGS. 3 and 4, the distal end portion 14 includes a base portion 30 fixed to the distal end of the bending portion 13, and a rotating portion 21 disposed so as to be rotatable with respect to the base portion 30. Configured. Specifically, in the present embodiment, the rotating portion 21 is supported by the base 30 so as to be rotatable around a rotation axis B substantially parallel to the insertion axis along the longitudinal direction of the insertion portion 11 with respect to the base 30. ing. The rotating part 21 is made of an electrically insulating material such as synthetic resin.

  The structure which supports the rotation part 21 with respect to the base 30 so that rotation is possible is not specifically limited. In this embodiment, as an example, cylindrical slide bearing portions 31 and 25 that are fitted to each other are formed at the distal end portion of the base portion 30 and the proximal end portion of the rotating portion 21. The rotating part 21 is disposed so as to be rotatable with respect to the base part 30 via the sliding bearing parts 31 and 25.

  Moreover, in the medical device 10 of this embodiment, the rotation part 21 is comprised so that it may rotate in response to rotation of the dial-shaped rotation operation part 45 provided in the operation part 40 mentioned later. . Specifically, an internal gear 26 is formed on the inner peripheral surface of the rotating portion 21, and an external gear 32 that meshes with the internal gear 26 and can rotate with respect to the base portion 30 is arranged on the base 30. It is installed.

  A drive shaft 33 that rotates in response to the rotation of the rotation operation unit 45 is inserted into the insertion unit 11, and the distal end portion of the drive shaft 33 is connected to the external gear 32. The force for rotating the drive shaft 33 is transmitted to the rotating unit 21 via the external gear 32 and the internal gear 26. The drive shaft 33 is configured to be capable of being bent according to the bending of the bending portion 13. Thus, in this embodiment, the user can remotely operate the rotation of the rotation unit 21 by operating the rotation operation unit 45 provided in the operation unit 40.

  A concave portion 20 is provided at the tip of the rotating portion 21. As shown in FIG. 4, the recess 20 opens in a direction that forms a predetermined angle θ with respect to the rotation axis B of the rotation portion 21 that is substantially parallel to the insertion axis of the insertion portion 11. In the present embodiment, the distal end portion of the rotating portion 21 is made of a substantially cylindrical member having the rotating shaft B as the central axis. The opening of the recess 20 is formed by cutting the substantially cylindrical rotating part 21 along a plane that intersects the rotating axis B at a predetermined angle θ. In other words, the rotating part 21 is configured by a cap member having a tapered tip. The concave portion 20 is provided with a bottom surface portion 24, and when the opening is closed, a closed space is formed in the concave portion 20.

  As described above, the medical device 10 of the present embodiment includes the concave portion 20 that is opened at a predetermined angle θ with respect to the insertion axis at the distal end portion 14 of the insertion portion 11. The opening direction of the recess 20 is configured to be rotatable around the insertion axis so that the state shown in FIG.

  In addition, it is preferable that the part which forms the recessed part 20 at least of the rotation part 21 is comprised by transparent materials, such as a synthetic resin, for example. By configuring the part that forms the recess 20 of the rotating part 21 with a transparent material, the user can easily observe the part to be treated. In addition, although the rotation part 21 of this embodiment to show in figure is substantially circular shape seeing from the direction in alignment with the rotation axis B, the movable part 21 may be polygonal shape.

  In the recess 20, the tip of the suction conduit 23 is connected. The suction conduit 23 is inserted through the insertion portion 11 and extends to the operation portion 40 described later. The proximal end of the suction conduit 23 is connected to the conduit connection port 42 of the operation unit 40.

  In the present embodiment, the suction conduit 23 is made of a flexible tubular member, and the tip is connected to the bottom surface 24 of the recess 20. Further, the suction conduit 23 is connected to the concave portion 20 so as to allow the rotation of the rotation portion 21 and the bending deformation of the bending portion 13. In the present embodiment, as an example, the suction pipe 23 is inserted into the insertion portion 11 with a predetermined margin in length so as not to prevent the rotation of the rotation portion 21 and the bending of the bending portion 13. Has been.

  Note that the suction pipe 23 may have a form in which the tip communicates with the recess 20, and may be arranged along the outer peripheral surface of the insertion part 11. Further, when the slide bearing portions 31 and 25 of the base portion 30 and the rotating portion 21 are configured to be airtight by a sealing member such as an O-ring, at least a part of the suction conduit 23 is a cylindrical rigid portion 12. Further, it may be configured by the bending portion 13 and the base portion 30.

  Further, a treatment instrument insertion conduit 22 is provided in the insertion portion 11. The treatment instrument insertion conduit 22 is made of a tubular member made of an electrically insulating material such as a synthetic resin, and a high-frequency snare 60 that is a treatment instrument can be inserted into the treatment instrument insertion duct 22. The treatment instrument insertion conduit 22 is disposed such that the distal end opens at the distal end portion 14 of the insertion portion 11. The proximal end side of the treatment instrument insertion conduit 22 extends into the operation unit 40 described later.

  In the present embodiment, the distal end of the treatment instrument insertion conduit 22 is provided in the recess 20 of the rotating unit 21. More specifically, the treatment instrument insertion conduit 22 is inserted into the insertion portion 11, and is disposed so that the distal end side penetrates the bottom surface portion 24 of the recess 20 and opens in the recess 20. . And the front-end | tip of the treatment tool penetration pipeline 22 is provided in the position where the depth of the rotation axis B direction of the recessed part 20 becomes the shallowest so that it may open toward the direction substantially parallel to the rotation axis B. .

  The treatment instrument insertion conduit 22 is disposed so as to allow the rotation of the rotation portion 21 and the bending deformation of the bending portion 13. In this embodiment, as an example, the treatment instrument insertion conduit 22 has a predetermined margin in the insertion portion 11 so as not to hinder the rotation of the rotation portion 21 and the bending of the bending portion 13. Is inserted. Note that the treatment instrument insertion conduit 22 may have a configuration in which the distal end is open near the distal end portion 14 and may be disposed along the outer peripheral surface of the insertion portion 11. Further, as described above, the suction conduit 23 and the treatment instrument insertion conduit 22 that open at the distal end portion 14 may be integrally formed in the insertion portion 11.

  Next, the configuration of the operation unit 40 will be described. In the present embodiment, the operation unit 40 has an outer shape that can be gripped by a human finger. The operation unit 40 includes a pipe connection port 42, a suction operation unit 41, a rotation operation unit 45, a cord connection unit 51, and a treatment instrument operation unit 50.

  The proximal end of the suction conduit 23 is connected to the conduit connection portion 42. In the present embodiment, the proximal end of the suction conduit 23 inserted through the insertion portion 11 and the operation portion 40 is opened at the conduit connection portion 42. As shown in FIG. 1, the pipe connection portion 42 has a connector shape in which the connection pipe 111 can be attached and detached, and is configured to be connectable to the suction device 110 via the connection pipe 111. The suction device 110 has an electric pump or the like and is configured to be able to make the inside of the connection pipe line 111 have a negative pressure.

  That is, in the medical device 10 of this embodiment, the inside of the recess 20 provided in the distal end portion 14 of the insertion portion 11 is connected to the suction device 110 via the suction conduit 23, the conduit connection portion 42, and the connection conduit 111. Communicate.

  The suction operation unit 41 is provided in the suction conduit 23 and has a configuration for operating whether or not the distal end side of the suction conduit 23 is substantially equal to the negative pressure generated by the suction device 110. . In the present embodiment, the suction operation unit 41 operates a valve member that can be in a communication state or a cutoff state between the inside of the suction pipe line 23 and the ambient atmosphere that is atmospheric pressure, and opens and closes the valve member. A lever member is provided.

  When the valve member of the suction operation unit 41 is opened, the inside of the suction line 23 communicates with the surrounding atmosphere, and the pressure of the suction line 23 becomes atmospheric pressure. On the other hand, when the valve member of the suction operation unit 41 is in the shut-off state, the pressure in the suction pipe line 23 is substantially the same as the negative pressure generated by the suction device 110. That is, the inside of the recessed part 20 provided in the front-end | tip part 14 of the insertion part 11 becomes negative pressure.

  Moreover, in this embodiment, the suction operation part 41 is arrange | positioned so that a user can operate a lever member with the index finger of the hand holding the lever member.

  The rotation operation unit 45 is a member for operating the rotation of the rotation unit 21 provided at the distal end portion 14 of the insertion unit 11 described above. In the present embodiment, the rotation operation unit 45 is a rotary dial provided so as to be rotatable with respect to the operation unit 40, and has a configuration for rotating the drive shaft 33 described above according to the rotation. Specifically, as shown in FIG. 5, bevel gears 46 and 34 that mesh with each other are provided at the proximal ends of the rotation operation unit 45 and the drive shaft 33. Therefore, in the present embodiment, the force for rotating the rotation operation unit 45 is transmitted to the rotation unit 21 via the drive shaft 33.

  Therefore, in the medical device 10 of the present embodiment, the rotation unit 21 is moved around the rotation axis B from the state illustrated in FIG. 3 to the state illustrated in FIG. 6, for example, according to the rotation of the rotation operation unit 45. Can be rotated.

  In the present embodiment, the rotation operation unit 45 is arranged so that the user can operate it with the thumb of the hand holding the holding unit 40.

  The treatment instrument operation unit 50 is a member for moving the high-frequency snare 60 inserted into the treatment instrument insertion conduit 22 forward and backward within the treatment instrument insertion conduit 22. In the present embodiment, the treatment instrument operation unit 50 is a lever-like member made of an electrically insulating member such as synthetic resin, which is fixed to the proximal end of the high-frequency snare 60.

  The treatment instrument operation unit 50 is disposed so as to be movable forward and backward with respect to the operation unit 40. The medical device 10 can change the protruding amount of the loop portion 61 of the high-frequency snare 60 protruding from the distal end of the treatment instrument insertion conduit 22 by moving the treatment instrument operation section 50 forward and backward.

  Specifically, when the treatment instrument operation unit 50 moves in a direction (advancing direction) to enter the operation unit 40, the high-frequency snare 60 is pressed in the distal direction, and as shown in FIG. It protrudes from the tip of the insertion duct 22. Further, when the treatment instrument operation unit 50 moves in the direction (withdrawal direction) to be pulled out from the operation unit 40, the high frequency snare 60 is pulled in the proximal direction, and the loop unit 61 is connected to the treatment instrument insertion conduit as shown in FIG. 22 is pulled into. That is, in the medical device 10 of the present embodiment, the amount of protrusion of the loop portion 61 of the high-frequency snare 60 can be changed by moving the treatment instrument operation portion 50 forward and backward.

  The cord connecting portion 51 is configured to have a form of an electrical connector for electrically connecting the A cord 102 to the high-frequency snare 60 inserted into the treatment instrument insertion conduit 22. The cord connection part 51 is provided so as to be movable with respect to the operation part 40 in accordance with the advance / retreat movement of the treatment instrument operation part 50 and the high-frequency snare 60.

  Next, a tissue excision procedure using the medical device 10 of the present embodiment will be described. First, the user inserts the insertion part 11 of the medical device 10 and the insertion part 4 of the endoscope 3 into the airway from the oral cavity. At this time, the suction operation unit 41 is operated so that the tip side of the suction conduit 23 does not become negative pressure. The treatment instrument operation unit 50 is pushed into the operation unit 40 side, and the loop part 61 of the high-frequency snare 60 is protruded from the distal end of the treatment instrument insertion conduit 22.

  Then, as shown in FIG. 8, physiological saline or the like is locally injected under the mucous membrane of the affected part 120 while observing with the endoscope 3. And the opening part 20 provided in the front-end | tip part 14 is closely_contact | adhered to the site | part in which the affected part 120 which performs excision treatment exists. And the suction operation part 41 is operated and the front-end | tip side of the suction pipe line 23 is made into a negative pressure. That is, the inside of the recess 20 is communicated with the suction device 110 via the suction conduit 23 to suck the inside of the recess 20.

  Then, as shown in FIG. 9, the site (tissue) where the affected part 120 exists is raised by the negative pressure and pulled into the recess 20. Further, at this time, the raised portion enters the loop portion 61 of the high-frequency snare 60. After confirming with the endoscope 3 that the site where the affected part 120 exists has been drawn into the recess 20, the treatment instrument operating unit 50 is moved in the direction of being pulled out of the operating unit 40.

  Then, as shown in FIG. 10, the peripheral length of the loop portion 61 of the high-frequency snare 60 is shortened, and the portion drawn into the recess 20 is squeezed by the loop portion 61. Then, by operating the foot switch 101 and causing a high-frequency current to flow through the loop part 61, the treatment tool operation part 50 is further moved in the direction of being pulled out from the operation part 40, so that the site where the affected part 120 exists is excised.

  As described above, the distal end portion 14 of the insertion portion 11 of the medical device 10 is provided with the recess 20, and the inside of the recess 20 communicates with the suction device 110 via the suction conduit 23. The recess 20 opens in a direction inclined by a predetermined angle θ with respect to the insertion axis of the insertion portion 11. In the medical device 10, since the concave portion 20 is provided in the rotating portion 21, the opening portion of the concave portion 20 is configured to be rotatable around the insertion axis of the insertion portion 11 in the opening direction.

  When the medical device 10 having such a configuration is used, the recess 20 is opened in advance in the airway so as to face the wall surface of the airway. Then, the user rotates the opening direction of the opening of the recess 20 while observing with the endoscope 3, so that the opening of the recess 20 can be easily and easily placed on the site where the affected part 120 to be excised is present. It can be brought into close contact accurately.

  Moreover, in this embodiment, since rotation of the rotation part 21 can be controlled by the rotation operation part provided in the operation part 40 which a user hold | grips, a user can hold the medical device 10 and The opening of the recess 20 can be brought into close contact with the site to be excised without changing the posture. Similarly, in the medical device 10 of the present embodiment, the user performs the suction of the tissue into the recess 20 and the strangulation of the tissue by the loop portion 61 of the high-frequency snare 60 while holding the medical device 10. These operations can be performed easily.

  As described above, according to the medical device 10 of the present embodiment and the medical system 1 including the medical device 10, it is possible to quickly and accurately perform a treatment on a part of the human airway.

  Further, the medical device 10 according to the present embodiment can bend the bending portion 13 of the insertion portion 11. For this reason, the concave portion 20 can be more easily brought into close contact with the site to be excised by bending the curved portion 13 in advance according to the shape of the airway or the position of the site to be excised. Treatment can be performed quickly.

  In the above-described embodiment, the rotation unit 21 is configured to rotate with respect to the base 30 by the external gear 32 and the internal gear 26 that are driven by the drive shaft 33 inserted through the insertion unit 11. The configuration for rotating the rotating unit 21 is not limited to this embodiment. For example, as shown in FIG. 11 as a first modified example, a cam groove 27 inclined with respect to the rotation axis B is formed in the rotation portion 21, and the cam pin 35 engaged with the cam groove 27 is connected to the rotation axis. A configuration in which the rotating unit 21 is rotated by moving it back and forth in a direction parallel to B may be employed. In the case of the form shown in FIG. 11, since the cam pin 35 can be moved back and forth by the wire inserted through the insertion portion 11, the mechanism can be simplified compared to the above-described embodiment.

  Further, for example, the rotating unit 21 may be driven to rotate by an electric motor provided at the distal end portion 14. Further, the medical device 10 may not be provided with a drive mechanism that rotates the rotation unit 21 and may be configured to hold the direction of the opening 20 at an arbitrary angle around the rotation axis B.

  In the embodiment described above, the opening shape of the recess 20 is fixed, but the opening shape of the recess 20 may be changeable. For example, as in the second modified example shown in FIGS. 12 and 13, the rotating part 220 is covered with the rotating part 220 on the outer periphery, and can be moved forward and backward in the rotating axis B direction with respect to the rotating part 220. The structure which provides the cylindrical part 221 may be sufficient. In such a second modified example, as shown in FIG. 12, when the cylindrical portion 221 is protruded to the tip side from the rotating portion 220, the opening shape of the concave portion 20 is that of the cylindrical portion 221. The opening shape is D1. Further, when the cylindrical portion 221 is moved to the base end side with respect to the distal end of the rotating portion 220, the opening shape of the recessed portion 20 becomes the opening shape D <b> 2 of the rotating portion 220. With such a configuration, the shape of the opening of the recess 20 can be immediately changed according to the size of the part to be excised, so that the excision can be performed quickly.

  The present invention is not limited to the above-described embodiment, and can be appropriately changed without departing from the gist or concept of the invention that can be read from the claims and the entire specification. Medical systems are also included in the technical scope of the present invention.

  The present invention can be applied to a medical device and a medical system that perform excision treatment on a part of the human respiratory tract under observation with an endoscope.

1 medical system,
2 laryngoscope,
3 Endoscope,
4 Insertion part,
5 Tip,
10 Medical equipment,
11 Insertion part,
12 Hard part,
13 Curved part,
14 tip,
20 recess,
21 rotating part,
22 Treatment instrument insertion conduit,
23 Suction line,
24 bottom part,
25 plain bearing,
26 Internal gear,
30 base,
31 Sliding bearing part,
32 External gear,
33 drive shaft,
34 Bevel gear,
40 operation unit,
41 Suction operation unit,
42 pipeline connection port,
45 rotation operation part,
46 Bevel gear,
50 treatment tool operation section,
51 cord connection,
60 High-frequency snare (treatment tool),
61 Loop part,
100 power supply,
101 foot switch,
102 A code,
103 P code,
110 suction device,
111 connection lines,
120 Affected area.

Claims (7)

An insertion part that can be inserted into the airway from the oral cavity;
A rotation part provided at a distal end of the insertion part and rotatable around an insertion axis of the insertion part;
A recess opening in a direction inclined with respect to the rotation axis of the rotation unit;
A suction line for sucking the inside of the recess connected to the recess;
A treatment instrument insertion conduit capable of projecting a treatment instrument for opening the distal end portion and excising the biological mucosa present in the recess;
Equipped with,
The concave portion is configured by a plurality of cylindrical portions that are coaxially arranged and relatively movable in the axial direction, and the opening shape of the concave portion is the cylinder located at the most distal end of the plurality of cylindrical portions. A medical device characterized by being determined by the opening shape of the shaped portion . An operation unit disposed at a proximal end of the insertion unit and grippable by a human finger;
A rotation control unit that is provided in the operation unit and operates to rotate the rotation unit;
The medical device according to claim 1, comprising: The cylindrical portion, the is disposed around shaft the rotation axis, the recess, the tip of the tubular portion, by cutting by a plane intersecting at a predetermined angle with respect to the pivot axis The medical device according to claim 1, wherein the medical device has an obtained shape. The medical device according to any one of claims 1 to 3, wherein the cylindrical portion is made of a transparent member.   The medical device according to any one of claims 1 to 4, wherein at least a part of the insertion portion is bendable, and is configured to be able to hold a curved shape. The medical device according to claim 1 , wherein the treatment tool is a high-frequency snare . A medical system comprising the medical device according to any one of claims 1 to 6.

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