JP6244615B2 - Endoscope catheter and endoscope treatment tool - Google Patents

Description

  The present invention relates to an endoscope catheter and an endoscope treatment tool used together with an endoscope.

  An endoscope treatment tool that is used together with an endoscope and removes stones and the like in a bile duct is known. For example, an endoscope treatment tool includes an endoscope catheter that is inserted through the endoscope, and a treatment tool body that is inserted through a lumen formed inside the endoscope catheter. The tip of the tool body is provided with a basket or the like for grasping a calculus in the bile duct (see Patent Documents 1 and 2, etc.).

Utility Model Registration No. 3132410 JP 2004-249093 A

  In the conventional single-lumen endoscope treatment tool disclosed in Patent Document 1 and the like, the treatment tool body and the guide wire are configured to pass through the same lumen and be exposed to the body cavity from the same opening. There is a problem that the guide wire gets in the way when holding a calculus or the like with the basket provided at the tip of the main body. The guide wire is also used when an operation is performed in which only one of the guide wire and the treatment instrument body is pulled into the lumen from the state exposed in the body cavity and the other is exposed from the lumen to the body cavity. In some cases, the treatment tool body interferes with each other, which hinders smooth operation.

  Therefore, as described in Patent Document 2, a method of using a two-lumen catheter tube and separating the lumen through which the treatment instrument main body and the guide wire are inserted can be considered. However, the two-lumen catheter tube has an adverse effect on the smooth positioning of the distal end of the catheter due to an increase in the thickness of the catheter and a decrease in the flexibility of the catheter tube. There is.

  The present invention has been made in view of such a situation, and an object of the present invention is to provide an endoscopic catheter and an endoscope that do not hinder a smooth operation of the treatment instrument body and can realize a smooth position operation of the distal end. It is to provide a treatment tool.

In order to achieve the above object, an endoscope catheter according to the present invention includes:
A main tube in which a main lumen capable of exposing and retracting the distal end of the treatment instrument body from the distal end side opening is formed;
A fixed portion fixed to the distal end portion of the main tube and having a length of 3 to 30 mm; and extending from the fixed portion to the proximal end side and not fixed to the main tube; And a guide wire tube having a guide wire lumen formed therein, the guide wire lumen having a free portion that can be separated from the distal end and exposing and retracting the distal end of the guide wire from the distal end side opening.

  The endoscope catheter according to the present invention has a guide wire tube in which a guide wire lumen inserted by a guide wire is formed separately from a main tube in which a main lumen inserted by the treatment instrument body is formed. The guide wire tube is fixed at the distal end with respect to the main tube. Since the main lumen of the treatment instrument body is separated from the guide wire lumen, interference between the guide wire and the treatment instrument body can be prevented, and smooth operation of the guide wire and the treatment instrument body can be realized.

  The length of the fixed portion of the guide wire tube is 3 to 30 mm. By ensuring that the length of the fixing portion is 3 mm or more, secure connection with the main tube is ensured, and by making the length of the fixing portion 30 mm or less, flexibility near the distal end of the main tube is achieved. It is possible to prevent the deterioration and to realize a smooth position operation of the endoscope catheter.

  In addition, by having the free portion, the length of the guide wire lumen can be increased while ensuring the flexibility of the main tube, so that the guide wire can be prevented from being accidentally detached from the guide wire tube. . Further, by having the free part, the operator can easily perform an operation of storing the distal end of the guide wire in the guide wire lumen. Therefore, according to such an endoscope catheter, the distal end of the guide wire is drawn into the guide wire lumen when the distal end of the treatment tool main body is exposed to crush the calculus, etc. A state in which the guide wire becomes an obstacle during the operation of the main body can be preferably avoided.

  For example, the periphery of the distal end portion of the main tube may be brazed in a bent shape.

  The distal end portion of the endoscope catheter can be advanced in a direction different from the extending direction of the distal end portion of the endoscope by brazing the periphery of the distal end portion in a bent shape. Therefore, according to such an endoscope catheter, the operator can smoothly guide the distal end portion of the main tube to a target position.

  For example, the guide wire tube may have a length of 30 to 1000 mm.

  The length of the guide wire tube in the endoscope catheter can be appropriately changed, but the distal end portion of the endoscope catheter has been advanced into the bile duct because the guide wire tube is 30 mm or longer. In some cases, the proximal end of the guidewire tube can be prevented from being exposed from the distal end opening of the endoscope channel. When the proximal end of the guide wire tube is exposed from the distal end opening of the endoscope channel, the guide wire tube is positioned at the periphery of the distal end opening of the endoscope channel when the endoscope catheter is retracted. There is a risk of being caught on the part and hindering smooth operation, but such a phenomenon can be prevented by setting the guide wire tube to 30 mm or more. Further, by setting the guide wire tube to 1000 mm or less, it is possible to reduce the frictional resistance between the guide wire tube and the inner wall of the endoscope channel, thereby realizing a smoother operation of the endoscope catheter.

  Further, for example, the distal end side opening of the main lumen may be larger than the distal end side opening of the guide wire lumen, and the outer diameter of the guide wire tube may be smaller than the outer diameter of the main tube.

  The distal end opening of the main lumen is made larger than the distal end opening of the guide wire lumen, and the outer diameter of the guide wire tube is made smaller than the outer diameter of the main tube to prepare for the distal end of the treatment instrument body. It is possible to effectively prevent the entire endoscope catheter from becoming thick while securing an opening diameter through which a treatment portion such as a basket can be passed.

  Further, the guide wire tube may be disposed so as to sandwich at least a part of the free portion with respect to the fixed portion, and may have an intermediate fixed portion fixed to the main tube.

  By providing the intermediate fixing portion, it is possible to enhance the integrity of the guide wire tube and the main tube.

An endoscopic treatment tool according to the present invention includes an endoscopic catheter according to any one of the above,
The treatment instrument main body comprising a wire and a treatment portion attached to a distal end portion of the wire, which is movable with respect to the main lumen.

  The endoscope treatment tool according to the present invention can realize smooth position operation of the distal end portion of the endoscope catheter without hindering smooth operation of the treatment tool body.

The treatment section may be a basket made of wire,
The endoscopic treatment tool may be a treatment tool that removes stones in the bile duct.

  An endoscopic treatment tool having a treatment tool body in which the treatment portion is a basket is preferably used for removing stones in the bile duct.

FIG. 1 is a schematic view of an endoscope treatment tool according to one embodiment of the present invention. 2 is a schematic cross-sectional view and a front view of a distal end portion of an endoscope catheter included in the endoscope treatment tool shown in FIG. FIG. 3 is a schematic cross-sectional view showing the form of each operation state around the distal end of the endoscope treatment tool shown in FIG. FIG. 4 is a conceptual diagram showing a use state of the endoscope treatment tool shown in FIG. FIG. 5 is a schematic cross-sectional view showing an operation state of the endoscope treatment tool according to the reference example. 6 is a partial cross-sectional view showing a modification of the endoscope catheter shown in FIG.

  DESCRIPTION OF EMBODIMENTS Hereinafter, an endoscope catheter and an endoscope treatment tool according to the present invention will be described in detail based on embodiments shown in the drawings.

  FIG. 1 is a schematic view of an endoscope treatment tool 10 according to an embodiment of the present invention. The endoscope treatment tool 10 is used together with an endoscope 80 indicated by a dotted line in FIG. The endoscope treatment tool 10 is used by being inserted into an endoscope channel 83 formed in the endoscope tube 82 from the proximal end side of the endoscope 80.

  The endoscope treatment tool 10 includes an operation unit 12, an endoscope catheter 20, a treatment tool body 40, and a guide wire 50. The operation unit 12 is connected to the proximal end of the endoscope catheter 20 and is formed inside the endoscope catheter 20 or a grip to be gripped when the operator operates the endoscope treatment tool 10. And a connector for installing an external flow path or the like connected to the lumen.

  The operation unit 12 can be formed of a resin material harder than the endoscope catheter 20 described later. For example, a thermoplastic resin such as polycarbonate, polyamide, polysulfone, polyacrylate, methacrylate-butadiene-styrene copolymer, For example, it can be formed of a metal such as SUS. The operation unit 12 is located outside the patient's body when performing the treatment with the endoscope treatment tool 10, and the operator moves the operation unit 12 to position the distal end of the endoscope catheter 20. To operate. Therefore, it is preferable that the operation unit 12 is formed into a shape and size that can be easily grasped by an operator with one hand.

  The endoscope catheter 20 includes a main tube 22 and a guide wire tube 32 attached to a distal end portion of the main tube 22. The proximal end of the main tube 22 of the endoscope catheter 20 is connected to the operation unit 12. The main tube distal end 27, which is the distal end of the main tube 22, can pass through the endoscope channel 83 and be exposed from the endoscope channel distal end side opening 84. Although the length of the main tube 22 is not specifically limited, For example, it is about 800-3500 mm.

  A main lumen 23 is formed inside the main tube 22 as shown in FIGS. The inner diameter of the main lumen 23 and the wall thickness of the main tube 22 are not particularly limited. For example, the inner diameter of the main lumen 23 is about 0.2 to 5.5 mm, and the wall thickness of the main tube 22 is about 0.01 to 0.4 mm. can do. The main lumen 23 is continuous from the distal end 27 to the proximal end of the main tube 22, and the treatment instrument main body 40 (see FIG. 1) is inserted into the main lumen 23. A contrast marker for confirming the position by X-ray contrast may be provided around the distal end portion 26 of the main tube 22.

  As shown in FIG. 1, the treatment tool body distal end 47, which is the distal end of the treatment tool body 40, can be exposed and retracted from the distal end side opening 24 (see FIG. 2) of the main lumen 23. That is, the operator moves the proximal end of the treatment tool body 40 via the operation unit 12 of the endoscope catheter 20 or directly, thereby performing the exposure / retraction operation of the treatment tool body distal end 47. Can be operated. The material of the main tube 22 is not particularly limited as long as it has appropriate flexibility. For example, polyethylene (PE) resin, polypropylene (PP) resin, polyvinyl chloride (PVC) resin, polycarbonate (PC) resin, It can be selected from fluorine resin, polyamide resin, acrylonitrile-styrene (AS) resin, silicone resin and the like.

  A guide wire tube 32 is attached to a main tube distal end portion 26 (see FIG. 2) which is a distal end portion of the main tube 22. As shown in FIG. 2A, the guide wire tube 32 includes a fixed portion 36 fixed to the main tube distal end portion 26 and a free portion 38 extending from the fixed portion 36 to the proximal end side. Have.

  The fixing portion 36 of the guide wire tube 32 is located on the distal end side of the guide wire tube 32 and is fixed so that the outer peripheral wall of the guide wire tube 32 in the fixing portion 36 is not separated from the outer peripheral wall of the main tube 22. Yes. Although the fixing method of the fixing | fixed part 36 is not specifically limited, For example, the method of adhere | attaching the outer peripheral walls of the guide wire tube 32 and the main tube 22, the method of welding outer peripheral walls, a guide wire with tape or a string-like material Examples include a method of binding the tube 32 and the main tube 22 and a method of fixing with a resin or metal ring. The length d1 of the fixing portion 36 of the guide wire tube 32 is preferably 3 to 30 mm, and more preferably 5 to 20 mm. By making the length of the fixing portion 36 equal to or longer than a predetermined length, it is possible to ensure the reliable connection with the main tube 22. Further, by making the length of the fixing portion 36 equal to or less than a predetermined length, it is possible to prevent the flexibility in the vicinity of the distal end 27 of the main tube 22 from being deteriorated.

  Unlike the fixed portion 36, the free portion 38 of the guide wire tube 32 is not fixed to the main tube 22 and can be separated from the main tube 22. However, since the free part 38 is connected to the fixed part 36 and constitutes the guide wire tube 32 integrally with the fixed part 36, the free part 38 is indirectly connected to the main tube 22 via the fixed part 36. Yes.

  Inside the guide wire tube 32, a guide wire lumen 33 is formed as shown in FIGS. 2 (a) and 2 (b). The inner diameter of the guide wire lumen 33 and the thickness of the guide wire tube 32 are not particularly limited. For example, the inner diameter of the guide wire lumen 33 is about 0.2 to 1.2 mm, and the thickness of the guide wire tube 32 is 0.01 to 0. About 2 mm. As shown in FIG. 2A, the guide wire lumen 33 is continuous from the distal end 37 to the proximal end 39 of the guide wire tube 32, and the guide wire lumen 33 includes a guide wire 50 (see FIG. 1). ) Is inserted.

  The fixing portion 36 of the guide wire tube 32 is preferably fixed to the main tube distal end portion 26 so that the guide wire tube distal end 37 and the main tube distal end 27 substantially coincide with each other. The distal end side opening 24 of the main lumen 23 is preferably larger than the guide wire lumen distal end side opening 34, and the outer diameter of the guide wire tube 32 is preferably smaller than the outer diameter of the main tube 22. Thereby, it is possible to effectively prevent the entire endoscope catheter 20 from becoming thick while securing an opening diameter through which the basket 46 provided at the distal end of the treatment instrument body 40 can pass. . Further, the length d3 of the guide wire tube 32 (the sum of the length d1 of the fixed portion 36 and the length d2 of the free portion 38) is not particularly limited, but the endoscopic catheter 20 can be smoothly operated. Therefore, it is preferably 30 to 1000 mm, and more preferably 50 to 500 mm.

  In the example shown in FIG. 2, the guide wire tube 32 is connected to the main tube 22 only by the fixing portion 36 fixed to the distal end portion 26 of the main tube 22. The connection mode with the tube 22 is not limited to this. For example, as shown in FIG. 6, the guide wire tube 32 is disposed so as to sandwich at least a part of the free portion 38 with respect to the fixing portion 36, and has an intermediate fixing portion 35 fixed to the main tube 22. May be. In this case, the position of the intermediate fixing portion 35 may be arranged so as to divide the free portion 38, or may be arranged at the proximal end portion 39 (see FIG. 2) of the guide wire tube 32. Further, the number of intermediate fixing portions 35 is not limited to one, and the guide wire tube 32 may include a plurality of intermediate fixing portions 35. The method for fixing the guide wire tube 32 and the main tube 22 in the intermediate fixing portion 35 is not particularly limited, and for example, the same fixing method as that for the fixing portion 36 can be used.

  As shown in FIG. 1, a guide wire distal end 57, which is the distal end of the guide wire 50, can be exposed and retracted from the guide wire lumen distal end side opening 34 (see FIG. 2). That is, the operator can manipulate the exposure / retraction operation of the guide wire distal end 57 by moving the proximal end portion of the guide wire 50 guided outside the body through the endoscope channel 83. it can. The material of the guide wire tube 32 is not particularly limited as long as it has appropriate flexibility. For example, polyethylene (PE) resin, polypropylene (PP) resin, polyvinyl chloride (PVC) resin, polycarbonate (PC) resin. , Fluororesin, polyamide resin, acrylonitrile-styrene (AS) resin, silicone resin, and the like.

  As shown in FIG. 1, a treatment instrument body 40 that is inserted through the main lumen 23 of the main tube 22 is connected to a basket 46 provided on the distal end side and a proximal end side of the basket 46. And a support wire 43 (see FIG. 3B) that continues to the operation unit 12 of the endoscope treatment tool 10. The basket 46 is composed of four elastic wires, and bulges in the radial direction by jumping out from the opening 23 on the distal end side of the main lumen, so that a calculus or the like can be held between the elastic wires. Yes. In addition, as shown in FIG. 3B, the basket 46 is elastically deformed so that the outer diameter becomes small when being drawn into the main lumen 23.

  The support wire 43 may be formed by extending one of the elastic wires constituting the basket 46, but an elastic wire different from the elastic wire constituting the basket 46 may be used. It may be configured to be connected to the proximal end side of 46. Although the wire diameter of the elastic wire and the support wire 43 which comprise the basket 46 is not specifically limited, For example, it can be set as about 0.1-1.5 mm. Further, the material of the basket 46 and the support wire 43 is not particularly limited, and examples thereof include nickel titanium alloy, stainless steel, gold, platinum, nickel, iron, titanium, aluminum, tin, zinc, tungsten, and the like. Is particularly preferred. The nickel titanium alloy is a kind of shape memory alloy, and the treatment instrument main body 40 made of the nickel titanium alloy prevents the kink of the wire and suitably controls the shape of the basket 46 when it jumps out of the main lumen 23. it can.

  In FIG. 1 and FIG. 3 and the like, the treatment instrument main body 40 provided with the basket 46 as a treatment portion at the distal end is described as an example, but the treatment instrument main body 40 is not limited to this. As a treatment tool main body 40, what has a structure which consists of a wire and the wire which functions as a treatment part is connected to the distal end of the wire arrange | positioned at the proximal end side is mentioned as a preferable example. Other examples of the treatment instrument main body 40 include grasping forceps (basket-type grasping forceps), balloon-type dilator (balloon catheter), a snare that applies high-frequency current and cauterizes with a loop-shaped wire, a high-frequency knife, and a hemostatic clip. It is done.

  The wire diameter of the guide wire 50 shown in FIG. 1 can be, for example, 0.2 to 1.2 mm, but may be a wire diameter that allows the guide wire 50 to move smoothly through the endoscope channel 83 and the guide wire lumen 33. If it does not specifically limit. The material of the guide wire 50 is not particularly limited, and examples thereof include shape memory alloys (NiTi, etc.), stainless steel, and resins. In addition, the wire which comprises the treatment tool main body 40 and the guide wire 50 may be a single wire, and may be a stranded wire or a coil tube.

  Hereinafter, an example of a method of using the endoscope treatment tool 10 will be described mainly using FIGS. 3 and 4. FIG. 4 shows one use state in the removal processing of the gallstones in the bile duct 94 by the endoscope treatment tool 10. First, before using the endoscope treatment tool 10, the distal end of the endoscope tube 82 is passed to the duodenum 91 and placed near the teat 92. 3A, the guide wire distal end 57 is exposed from the endoscope channel distal end opening 84, and the guide wire distal end 57 is placed inside the bile duct 94 shown in FIG. insert.

Next, as shown in FIGS. 4 and 3B, the main tube distal end 27 and the guide wire tube distal end 37 are placed in the bile duct 94 along the guide wire 50 that has been inserted into the bile duct 94 in advance. insert. At this time, the guide wire tube 32 of the endoscope catheter 20 is inserted through the guide wire 50, and the guide wire distal end 57 is exposed from the guide wire lumen distal end side opening 34. Therefore, the guide wire tube distal end 37 inserted through the guide wire 50 and the main tube distal end 27 connected thereto can smoothly advance into the bile duct 94 along the guide wire 50. As shown in FIG. 4, in a state where the distal end 27 of the main tube 22 is disposed in the bile duct 94, a contrast medium is poured into the bile duct 94 via the main lumen 23 as necessary, and the X You may observe with a line.

  Thereafter, as shown in FIG. 3C, the guide wire distal end 57 is drawn from the guide wire lumen distal end side opening 34 to the guide wire lumen 33, and the guide wire distal end 57 is positioned inside the guide wire lumen 33. Let Further, the basket 46 of the treatment instrument main body 40 stored in the main lumen 23 is ejected from the opening 24 on the distal end side of the main lumen, and the calculus in the bile duct 94 is gripped by the basket 46, and this is crushed or removed. To do.

  Further, when it becomes necessary to change the position of the main tube distal end 27, the guide wire distal end 57 is again inserted into the guide wire lumen distal end opening 34, as shown in FIG. And the main tube distal end 27 (and the guide wire tube distal end 37) can be moved along the guide wire 50. When the calculus is removed from the bile duct 94 by pulling the basket 46 to the duodenum 91 while the calculus is held by the basket 46, the basket 46 is left protruding from the main lumen 23. The position of the main tube distal end 27 may be changed.

  As described above, the endoscope catheter 20 is configured such that the guide lumen 50 and the treatment instrument body 40 interfere with each other because the main lumen 23 in which the treatment instrument body 40 moves is separated from the guide wire lumen 33. Therefore, smooth operation of the guide wire 50 and the treatment instrument main body 40 can be realized.

  As shown in FIG. 5, the endoscope catheter 98 according to the prior art has a problem that the guide wire passes through the expanded basket and obstructs the holding of the calculus by the basket. However, as shown in FIG. 3C, the endoscope catheter 20 pulls the guide wire distal end 57 into the guide wire lumen 33 when the calculus is gripped using the basket 46. The guide wire 50 can be easily accommodated in a state where there is no hindrance to the treatment by 46. Further, when it becomes necessary to change the position of the main tube distal end 27, the guide wire tube distal end 37 can be quickly exposed from the guide wire lumen distal end side opening 34.

  As shown in FIG. 2, the guide wire tube 32 of the endoscope catheter 20 has a fixed portion 36 and a free portion 38. If an ordinary two-lumen tube in which the guide wire lumen cannot be separated from the main lumen over the entire length from the distal end to the proximal end is used as the endoscope catheter, the total thickness of the endoscope catheter is reduced. A problem arises in that the thickness increases and the flexibility of the endoscope catheter deteriorates. In particular, the distal end of the endoscope catheter is required to be flexible so that it can be freely deformed according to the operation from the operation unit. However, in addition to the main lumen, the guide wire lumen must also be deformed. The two-lumen tube cannot fully meet that requirement.

  However, as shown in FIG. 2, in the endoscope catheter 20 according to the present embodiment, since the length of the fixing portion 36 is as short as 3 to 30 mm, the periphery of the distal end portion of the endoscope catheter 20 is It has flexibility that can be freely deformed in response to an operation from the operation unit 12. That is, the free portion 38 of the guide wire tube 32 is not fixed to the main tube 22, and therefore hardly disturbs the flexibility of the main tube 22. This is because the free portion 38 of the guide wire tube 32 can be freely separated from the main tube 22 when the periphery of the distal end portion of the main tube 22 is to be bent. This is because the guide wire tube 32 can be deformed independently of the portion where the 36 is fixed.

  In addition, the guide wire tube 32 having the free portion 38 can ensure a sufficient length for temporarily storing the guide wire distal end 57 (see FIG. 3C). Although the total length d3 (refer FIG. 2) of the guide wire tube 32 is not specifically limited, It is preferable to set it as 30-1000 mm. By setting the length d3 of the guide wire tube 32 to 30 mm or more, the guide wire distal end 57 can be easily positioned in the guide wire lumen 33, and the guide wire distal end 57 is retracted when retracted. The momentum can be prevented from falling off the proximal end 39 of the guide wire tube.

  Further, by setting the length of the guide wire tube 32 to 30 mm or more, the distal ends 27 and 37 of the main tube 22 and the guide wire tube 32 are placed in the bile duct 94 as shown in FIGS. When advanced, the guide wire tube proximal end 39 can be prevented from being exposed from the endoscope channel distal end side opening 84. When the proximal end 39 of the guide wire tube is exposed from the opening 84 on the distal end side of the endoscope channel, when the other endoscopic treatment instrument 10 is pulled out from the endoscope channel 83 while leaving only the guide wire 50, the guide wire is removed. The tube proximal end 39 may be caught around the endoscope channel distal end side opening 84 and such a treatment may be difficult. However, by making the length of the guide wire tube 32 to be 30 mm or more, Can be prevented. Further, by setting the length of the guide wire tube 32 to 1000 mm or less, the friction resistance between the guide wire tube 32 and the inner wall of the endoscope channel 83 is reduced, and smoother operation of the endoscope catheter 20 is realized. can do. Further, by setting the length of the guide wire tube 32 to 1000 mm or less, the short guide wire 50 can be used, and the operation of the guide wire 50 and the endoscope treatment instrument 10 including the guide wire 50 can be facilitated.

Other Embodiments The endoscope treatment tool 10 according to the above-described embodiments can be variously modified. For example, the periphery of the main tube distal end portion 26 shown in FIG. 1 may be brazed in a bent shape. As shown in FIG. 4, when the main tube distal end 26 is advanced from the nipple 92 into the bile duct 94, the main tube distal end 26 is connected to the extending direction of the endoscope tube 82 and the endoscope channel 83. Need to be advanced in different directions, but such an operation can be easily performed by brazing the periphery of the main tube distal end portion 26 in a bent shape. The method of brazing the periphery of the main tube distal end portion 26 in a bent shape is not particularly limited. For example, after fixing the periphery of the main tube distal end portion 26 so as to have a bent shape, the main tube distal end portion is fixed in this state. It can be performed by a method of heating and cooling the periphery of the portion 26, a method of pressing and stretching the main tube with a finger or the like, and the like.

DESCRIPTION OF SYMBOLS 10 ... Endoscopic treatment tool 12 ... Operation part 20 ... Endoscope catheter 22 ... Main tube 23 ... Main lumen 24 ... Main lumen distal end side opening 26 ... Main tube distal end part 27 ... Main tube distal end 32 ... Guide wire tube 33 ... Guide wire lumen 34 ... Guide wire lumen distal end side opening 35 ... Intermediate fixing part 36 ... Fixing part 37 ... Guide wire tube distal end 38 ... Free part 39 ... Guide wire tube proximal end 40 ... treatment tool body 43 ... support wire 46 ... basket 47 ... treatment tool body distal end 50 ... guide wire 57 ... guide wire distal end 80 ... endoscope 82 ... endoscope tube 83 ... endoscope channel 84 ... inside End opening of endoscopic channel 91 ... Duodenum 92 ... Nipple 94 ... Bile duct

Claims (7)

A main tube in which a main lumen capable of exposing and retracting the distal end of the treatment instrument body from the distal end side opening is formed;
A fixed portion fixed to the distal end portion of the main tube and having a length of 3 to 30 mm; and extending from the fixed portion to the proximal end side and not fixed to the main tube; And a guide wire tube having a guide wire lumen formed therein, the guide wire lumen having a free portion that is separable from the distal end opening and exposing and retracting the distal end of the guide wire from the distal end opening. Mirror catheter.   The endoscope catheter according to claim 1, wherein the periphery of the distal end portion of the main tube is brazed in a bent shape.   The endoscope catheter according to claim 1 or 2, wherein the guide wire tube has a length of 30 to 1000 mm.   The distal end side opening of the main lumen is larger than the distal end side opening of the guide wire lumen, and the outer diameter of the guide wire tube is smaller than the outer diameter of the main tube. The endoscope catheter according to any one of 3 to 3.   The said guide wire tube is arrange | positioned on both sides of at least one part of the said free part with respect to the said fixing | fixed part, and has an intermediate | middle fixing | fixed part fixed to the said main tube. The endoscope catheter according to any one of 4 to 4. An endoscope catheter according to any one of claims 1 to 5,
An endoscope treatment instrument comprising: a treatment tool main body comprising a wire and a treatment part which is movable on the main lumen and attached to a distal end portion of the wire. The treatment portion is a basket made of wire,
The endoscope treatment tool according to claim 6, which is used for removing a calculus in a bile duct.

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