JP7000754B2

JP7000754B2 - Advanced treatment tool for high frequency treatment tool and high frequency treatment tool for medical use

Info

Publication number: JP7000754B2
Application number: JP2017174239A
Authority: JP
Inventors: 幸彦坂口; 昌夫池田; 靖久石井; 新悦原田; 康人伊丹
Original assignee: Sumitomo Bakelite Co Ltd
Current assignee: Sumitomo Bakelite Co Ltd
Priority date: 2017-09-11
Filing date: 2017-09-11
Publication date: 2022-01-19
Anticipated expiration: 2037-09-11
Also published as: JP2019047959A

Description

本発明は、高周波処置具用先端処置具、及び、医療用の高周波処置具に関する。 The present invention relates to a tip treatment tool for high frequency treatment tools and a high frequency treatment tool for medical use.

体腔内で生体組織を切開する処置（病変部位を切除する処置を含む）を行うための医療用器具として、内視鏡の鉗子孔に挿入して用いられる高周波処置具が知られている。 As a medical instrument for performing a procedure for incising a living tissue in a body cavity (including a procedure for excising a lesion site), a high-frequency treatment tool used by inserting it into a forceps hole of an endoscope is known.

例えば、特許文献１には、開閉可能な一対の開閉部を含む先端処置具（高周波処置具用先端処置具）を先端部に備える高周波処置具について記載されている。 For example, Patent Document 1 describes a high-frequency treatment tool having a tip treatment tool (tip treatment tool for high-frequency treatment tool) including a pair of opening / closing portions that can be opened and closed.

国際公開第２０１１－０４３３４０号パンフレットInternational Publication No. 2011-0433340 Pamphlet

しかしながら、本願発明者の検討によれば、特許文献１の技術では、内視鏡の先端から先端処置具を突出させて一対の開閉部を開いて処置を行う際に、内視鏡の先端（例えばフードの先端）に対して一対の開閉部が干渉しやすい。 However, according to the study of the inventor of the present application, in the technique of Patent Document 1, when the tip treatment tool is projected from the tip of the endoscope and the pair of opening / closing portions are opened for treatment, the tip of the endoscope ( For example, the pair of opening / closing portions easily interfere with the tip of the hood.

本発明は、上記の課題に鑑みてなされたものであり、内視鏡の先端との干渉を抑制することが可能な構造の高周波処置具用先端処置具、及び、医療用の高周波処置具を提供するものである。 The present invention has been made in view of the above problems, and a tip treatment tool for a high-frequency treatment tool having a structure capable of suppressing interference with the tip of an endoscope, and a high-frequency treatment tool for medical use are provided. It is to provide.

本発明は、医療用の高周波処置具の先端部に設けられ、内視鏡の鉗子孔に挿入して用いられて生体組織を切開する高周波処置具用先端処置具であって、
それぞれライン状の形状の電極が形成され、共通の回転軸において軸支されて相互に開閉可能となっており、前記生体組織を剪断又は挟持して高周波切除する一対の開閉部により構成された先端処置部を備え、
前記一対の開閉部が閉じた状態で、前記回転軸の軸方向に視たときの前記先端処置部の先端側の部分の形状が、先端から基端に向けて幅広になった後、幅狭になる形状である高周波処置具用先端処置具を提供するものである。 The present invention is a tip treatment tool for a high frequency treatment tool, which is provided at the tip of a high frequency treatment tool for medical use and is used by inserting it into a forceps hole of an endoscope to incise a living tissue.
Each line-shaped electrode is formed, and it is pivotally supported on a common rotation axis so that it can be opened and closed mutually. Equipped with a treatment section
With the pair of opening / closing portions closed, the shape of the tip-side portion of the tip-treated portion when viewed in the axial direction of the rotation axis becomes wider from the tip to the base end and then narrows. It is intended to provide a tip treatment tool for a high frequency treatment tool having a shape of

また、本発明は、本発明の高周波処置具用先端処置具を先端部に有し、基端側には、前記一対の開閉部の開閉操作を行うための操作部を有する医療用の高周波処置具を提供するものである。 Further, the present invention has a tip treatment tool for a high frequency treatment tool of the present invention at a tip portion, and a medical high frequency treatment having an operation portion for opening and closing the pair of opening / closing portions on the proximal end side. It provides the ingredients.

本発明によれば、高周波処置具用先端処置具の一対の開閉部と内視鏡の先端との干渉を抑制することが可能となる。 According to the present invention, it is possible to suppress the interference between the pair of opening / closing portions of the tip treatment tool for high-frequency treatment tools and the tip of the endoscope.

第１実施形態に係る医療用の高周波処置具の全体構造を示す模式図である。It is a schematic diagram which shows the whole structure of the high frequency treatment tool for medical use which concerns on 1st Embodiment. 第１実施形態に係る医療用の高周波処置具が先端部に備える高周波処置具用先端処置具の側面図であり、一対の開閉部が閉じた状態を示す。It is a side view of the tip treatment tool for a high frequency treatment tool which the medical high frequency treatment tool which concerns on 1st Embodiment is provided in the tip part, and shows the state which a pair of opening and closing parts are closed. 第１実施形態に係る医療用の高周波処置具が先端部に備える高周波処置具用先端処置具の側面図であり、一対の開閉部が開いた状態を示す。It is a side view of the tip treatment tool for a high frequency treatment tool which the medical high frequency treatment tool which concerns on 1st Embodiment has in the tip part, and shows the state which a pair of opening and closing parts are open. 第１実施形態に係る医療用の高周波処置具が先端部に備える高周波処置具用先端処置具の平面図であり、一対の開閉部が閉じた状態を示す。It is a top view of the tip treatment tool for the high frequency treatment tool which the medical high frequency treatment tool which concerns on 1st Embodiment has in the tip part, and shows the state which a pair of opening and closing parts are closed. 図２のＡ－Ａ線に沿った切断端面図である。It is a cut end view along the line AA of FIG. 第１実施形態に係る医療用の高周波処置具が先端部に備える高周波処置具用先端処置具が内視鏡の先端に設けられたフードから突出した状態を示す側面図である。It is a side view which shows the state which the tip treatment tool for a high frequency treatment tool which the medical high frequency treatment tool which concerns on 1st Embodiment is provided in the tip portion protrudes from the hood provided in the tip of an endoscope. 第２実施形態に係る医療用の高周波処置具が先端部に備える高周波処置具用先端処置具の側面図であり、一対の開閉部が閉じた状態を示す。It is a side view of the tip treatment tool for a high frequency treatment tool which the medical high frequency treatment tool which concerns on 2nd Embodiment has in the tip part, and shows the state which a pair of opening and closing parts are closed. 第２実施形態に係る医療用の高周波処置具が先端部に備える高周波処置具用先端処置具の側面図であり、一対の開閉部が開いた状態を示す。It is a side view of the tip treatment tool for a high frequency treatment tool which the medical high frequency treatment tool which concerns on 2nd Embodiment has in the tip part, and shows the state which a pair of opening and closing parts are open. 第２実施形態に係る高周波処置具用先端処置具の一方の開閉部の先端部の斜視図である。It is a perspective view of the tip portion of one opening / closing part of the tip treatment tool for high frequency treatment tool which concerns on 2nd Embodiment.

以下、本発明の実施形態について、図面を用いて説明する。なお、すべての図面において、同様の構成要素には同一の符号を付し、適宜に説明を省略する。
本実施形態に係る医療用の高周波処置具の各種の構成要素は、個々に独立した存在である必要はなく、複数の構成要素が一個の部材として形成されていること、一つの構成要素が複数の部材で形成されていること、ある構成要素が他の構成要素の一部であること、ある構成要素の一部と他の構成要素の一部とが重複していること、等を許容する。 Hereinafter, embodiments of the present invention will be described with reference to the drawings. In all the drawings, the same components are designated by the same reference numerals, and the description thereof will be omitted as appropriate.
The various components of the medical high-frequency treatment tool according to the present embodiment do not have to be individually independent, and a plurality of components are formed as one member, and one component is a plurality. It is allowed that it is formed of the members of the above, that one component is a part of another component, that a part of one component overlaps with a part of another component, and the like. ..

〔第１実施形態〕
先ず、図１から図６を用いて第１実施形態を説明する。
図２及び図３に示す側面図では、シース７０において図示した範囲のうち、基端側の部分については、中心線に沿った側断面を示している。
以下の説明において、先端処置部１０の先端方向とは、回転軸（軸部材６１）の軸中心６１ａから先端処置部１０（開閉部１０ａ、１０ｂ）の先端（図２における先端処置部１０の左端）に向かう方向のことであり、先端処置部１０の基端方向とは、その逆方向のことである。したがって、先基端方向とは、図２における左右方向である。 [First Embodiment]
First, the first embodiment will be described with reference to FIGS. 1 to 6.
In the side views shown in FIGS. 2 and 3, in the range shown in the sheath 70, the portion on the proximal end side shows a side cross section along the center line.
In the following description, the tip direction of the tip treatment portion 10 is from the axis center 61a of the rotating shaft (shaft member 61) to the tip of the tip treatment portion 10 (opening / closing portion 10a, 10b) (the left end of the tip treatment portion 10 in FIG. 2). ), And the base end direction of the tip treatment portion 10 is the opposite direction. Therefore, the tip base end direction is the left-right direction in FIG.

図１から図４のいずれかに示すように、本実施形態に係る高周波処置具用先端処置具１００は、医療用の高周波処置具２００（以下、単に高周波処置具２００と称する場合がある）の先端部に設けられ、内視鏡３００（図７には内視鏡３００の先端部のフード３１０における先端側の部分を示している）の鉗子孔（不図示）に挿入して用いられて生体組織（不図示）を切開する高周波処置具用先端処置具１００である。
本実施形態に係る高周波処置具用先端処置具１００としては、一対のカップ状の開閉部を有する生検鉗子を除く。
高周波処置具用先端処置具１００は、一対の開閉部１０ａ、１０ｂにより構成された先端処置部１０を備えている。一対の開閉部１０ａ、１０ｂにはそれぞれライン状（線状）の形状の電極５２が形成されている。なお、ライン状の形状の電極５２とは、一対のカップ状の開閉部を有する生検鉗子にみられるような環状又はＵ字状の電極ではない。なお、電極５２は、部分ごとに高低差が存在していたり、蛇行していたりしてもよい。
一対の開閉部１０ａ、１０ｂは、共通の回転軸（図２、図３に示す軸部材６１）において軸支されて相互に開閉可能となっており、生体組織を剪断又は挟持して高周波切除する。
一対の開閉部１０ａ、１０ｂは、板状又は棒状の形状であり、カップ状の形状ではない。
一対の開閉部１０ａ、１０ｂが閉じた状態で、上記回転軸の軸方向（図２の紙面に対して直交する方向）に視たときの先端処置部１０の先端側の部分の形状が、先端から基端に向けて幅広になった後、幅狭になる形状である。ここでいう幅広又は幅狭とは一対の開閉部１０ａ、１０ｂの開き方向（図２における上下方向）において幅広又は幅狭という意味である。
換言すれば、一対の開閉部１０ａ、１０ｂが閉じた状態で、上記回転軸の軸方向（図２の紙面に対して直交する方向）に視たときの先端処置部１０の先端側の部分の形状が、基端から先端に向けて幅広になった後、幅狭になる形状である。
先端処置部１０とは、一対の開閉部１０ａ、１０ｂにおいて上記回転軸（軸部材６１）よりも先端側に位置する部分であり、本実施形態の場合、一対の開閉部１０ａ、１０ｂにおいて、保持枠８０のブラケット８２から先端側に突出している部分が先端処置部１０である。 As shown in any one of FIGS. 1 to 4, the advanced treatment tool 100 for a high-frequency treatment tool according to the present embodiment is a medical high-frequency treatment tool 200 (hereinafter, may be simply referred to as a high-frequency treatment tool 200). A living body provided at the tip and inserted into a forceps hole (not shown) of the endoscope 300 (FIG. 7 shows a portion of the tip of the endoscope 300 on the tip side of the hood 310). It is a tip treatment tool 100 for a high frequency treatment tool that incises a tissue (not shown).
The tip treatment tool 100 for high-frequency treatment tools according to the present embodiment excludes biopsy forceps having a pair of cup-shaped opening / closing portions.
The tip treatment tool 100 for a high frequency treatment tool includes a tip treatment portion 10 composed of a pair of opening / closing portions 10a and 10b. A linear (linear) shaped electrode 52 is formed on each of the pair of opening / closing portions 10a and 10b. The line-shaped electrode 52 is not an annular or U-shaped electrode as seen in biopsy forceps having a pair of cup-shaped opening / closing portions. The electrode 52 may have a height difference for each portion or may meander.
The pair of opening / closing portions 10a and 10b are pivotally supported by a common rotation axis (shaft member 61 shown in FIGS. 2 and 3) and can be opened / closed with each other, and the living tissue is sheared or sandwiched to perform high-frequency excision. ..
The pair of opening / closing portions 10a and 10b have a plate-like or rod-like shape, not a cup-like shape.
With the pair of opening / closing portions 10a and 10b closed, the shape of the tip side portion of the tip treatment portion 10 when viewed in the axial direction of the rotation axis (direction orthogonal to the paper surface of FIG. 2) is the tip. It is a shape that widens from to the base end and then narrows. The term "wide or narrow" as used herein means wide or narrow in the opening direction (vertical direction in FIG. 2) of the pair of opening / closing portions 10a and 10b.
In other words, with the pair of opening / closing portions 10a and 10b closed, the portion on the tip end side of the tip treatment portion 10 when viewed in the axial direction of the rotation axis (direction orthogonal to the paper surface of FIG. 2). The shape is widened from the base end to the tip end and then narrowed.
The tip treatment portion 10 is a portion of the pair of opening / closing portions 10a and 10b located on the tip side of the rotation shaft (shaft member 61), and in the case of the present embodiment, the tip opening / closing portions 10a and 10b hold the tip treatment portion 10. The portion of the frame 80 protruding toward the tip side from the bracket 82 is the tip treatment portion 10.

また、本実施形態に係る医療用の高周波処置具２００は、本実施形態に係る高周波処置具用先端処置具１００を先端部に有し、基端側には、一対の開閉部１０ａ、１０ｂの開閉操作を行うための手元操作部（操作部）９０を有する。 Further, the medical high frequency treatment tool 200 according to the present embodiment has the tip treatment tool 100 for the high frequency treatment tool according to the present embodiment at the tip portion, and a pair of opening / closing portions 10a and 10b are provided on the proximal end side. It has a hand operation unit (operation unit) 90 for performing an opening / closing operation.

本実施形態によれば、一対の開閉部１０ａ、１０ｂが閉じた状態で、上記回転軸の軸方向に視たときの先端処置部１０の先端側の部分の形状が、先端から基端に向けて幅広になった後、幅狭になる形状となっていることにより、図６に示すように、内視鏡３００の先端から先端処置部１０を突出させ、一対の開閉部１０ａ、１０ｂを開いて処置を行なう際に、内視鏡３００の先端（例えばフード３１０の先端）に対する一対の開閉部１０ａ、１０ｂの干渉を抑制することができる。
また、先端処置部１０が内視鏡３００の鉗子孔（不図示）の周壁に対してほぼ点接触するため、高周波処置具用先端処置具１００を鉗子孔内で前進させる動作をスムーズにすることができる。
また、一対の開閉部１０ａ、１０ｂどうしを開いた状態で回転操作することもあり、その場合に、一対の開閉部１０ａ、１０ｂと、これら一対の開閉部１０ａ、１０ｂの背後に位置する生体組織と、の干渉を抑制できる。 According to the present embodiment, in a state where the pair of opening / closing portions 10a and 10b are closed, the shape of the portion on the tip end side of the tip treatment portion 10 when viewed in the axial direction of the rotation axis is directed from the tip end to the base end. As shown in FIG. 6, the tip treatment portion 10 is projected from the tip of the endoscope 300, and the pair of opening / closing portions 10a and 10b are opened. It is possible to suppress the interference of the pair of opening / closing portions 10a and 10b with the tip of the endoscope 300 (for example, the tip of the hood 310) when performing the treatment.
Further, since the tip treatment portion 10 makes a substantially point contact with the peripheral wall of the forceps hole (not shown) of the endoscope 300, the operation of advancing the tip treatment tool 100 for a high frequency treatment tool in the forceps hole is smoothed. Can be done.
Further, the pair of opening / closing portions 10a and 10b may be rotated while being opened, and in that case, the pair of opening / closing portions 10a and 10b and the biological tissue located behind the pair of opening / closing portions 10a and 10b. And, the interference can be suppressed.

本実施形態の場合、医療用の高周波処置具２００は鋏鉗子であり、一対の開閉部１０ａ、１０ｂの各々は、薄板状の剪断鋏部であり、これら一対の開閉部１０ａ、１０ｂを軸支している軸部材６１の軸方向は、これら一対の開閉部１０ａ、１０ｂの厚み方向に延在している。
一対の開閉部１０ａ、１０ｂの各々は、生体組織を剪断する刃部５０をそれぞれ有している。
より詳細には、一対の開閉部１０ａ、１０ｂの各々は、一対の開閉部１０ａ、１０ｂの各々の基端側に形成されていて上記回転軸において軸支されている基端片２０と、一対の開閉部１０ａ、１０ｂの各々の先端に形成されている先端爪部４０と、一対の開閉部１０ａ、１０ｂの各々における先端爪部４０と基端片２０との間に形成されている刃部５０と、を有する。刃部５０には上記のライン状の電極５２が形成されている。 In the case of the present embodiment, the medical high-frequency treatment tool 200 is a pair of scissors forceps, and each of the pair of opening / closing portions 10a and 10b is a thin plate-shaped shearing scissors portion, and the pair of opening / closing portions 10a and 10b are pivotally supported. The axial direction of the shaft member 61 extends in the thickness direction of the pair of opening / closing portions 10a and 10b.
Each of the pair of opening / closing portions 10a and 10b has a blade portion 50 for shearing the biological tissue.
More specifically, each of the pair of opening / closing portions 10a and 10b is paired with the proximal end piece 20 formed on the proximal end side of each of the pair of opening / closing portions 10a and 10b and pivotally supported on the rotation axis. The tip claw portion 40 formed at the tip of each of the opening / closing portions 10a and 10b of the above, and the blade portion formed between the tip claw portion 40 and the base end piece 20 of each of the pair of opening / closing portions 10a and 10b. It has 50 and. The above-mentioned line-shaped electrode 52 is formed on the blade portion 50.

図１に示すように、高周波処置具２００は、長尺な操作ワイヤ６８と、操作ワイヤ６８の先端に設けられた高周波処置具用先端処置具１００と、操作ワイヤ６８が収容された可撓性のシース７０と、シース７０の基端側に設けられて操作ワイヤ６８の基端が接続された手元操作部９０と、を備えている。 As shown in FIG. 1, the high-frequency treatment tool 200 includes a long operation wire 68, a high-frequency treatment tool tip treatment tool 100 provided at the tip of the operation wire 68, and a flexibility in which the operation wire 68 is housed. The sheath 70 is provided with a hand operation unit 90 provided on the base end side of the sheath 70 and to which the base end of the operation wire 68 is connected.

シース７０は、操作ワイヤ６８を収容する長尺かつ管状の部材である。本実施形態の場合、シース７０は、ステンレス線等の導電性ワイヤを密着巻回して作製された、金属製のコイル７１（図２、図３）である。シース７０の外表面には絶縁性被膜７２が密着して設けられている。ただしシース７０としては、金属製のコイル７１に代えて絶縁性の管状部材（チューブ）を用いてもよい。 The sheath 70 is a long and tubular member that houses the operation wire 68. In the case of the present embodiment, the sheath 70 is a metal coil 71 (FIGS. 2 and 3) manufactured by tightly winding a conductive wire such as a stainless wire. An insulating coating 72 is provided in close contact with the outer surface of the sheath 70. However, as the sheath 70, an insulating tubular member (tube) may be used instead of the metal coil 71.

図１に示す手元操作部９０は、操作ワイヤ６８が挿通された軸部９５と、この軸部９５の基端部に設けられた指掛リング９２と、操作ワイヤ６８の基端が連結されて軸部９５に対して進退移動するスライダ９３と、を備えている。操作ワイヤ６８は軸部９５に対して摺動可能に挿通されている。ユーザは、指掛リング９２に例えば親指を挿入し、スライダ９３を他の２本の指で挟んで軸部９５の長手方向に沿って進退駆動する。これにより、操作ワイヤ６８は手元操作部９０に対して前進または後退する。シース７０の基端は手元操作部９０に固定され、操作ワイヤ６８はシース７０に対して進退可能に挿通されているため、スライダ９３の進退移動に連動して操作ワイヤ６８の先端はシース７０に対して前進または後退する。これにより、後述するように、高周波処置具用先端処置具１００の進退部６７（図２、図３）が進退駆動されて、一対の開閉部１０ａ、１０ｂが開閉する。
一対の開閉部１０ａ、１０ｂの回転軸の軸方向は、一対の開閉部１０ａ、１０ｂの板面に対して直交する方向であり、一対の開閉部１０ａ、１０ｂが開閉する際には、一対の開閉部１０ａ、１０ｂの互いの対向面１６（図５参照）の一部分どうしが摺動する。 In the hand operation unit 90 shown in FIG. 1, the shaft portion 95 through which the operation wire 68 is inserted, the finger hook ring 92 provided at the base end portion of the shaft portion 95, and the base end of the operation wire 68 are connected to each other. A slider 93 that moves forward and backward with respect to the shaft portion 95 is provided. The operation wire 68 is slidably inserted through the shaft portion 95. The user inserts, for example, a thumb into the finger hook ring 92, sandwiches the slider 93 with two other fingers, and drives the slider 93 forward and backward along the longitudinal direction of the shaft portion 95. As a result, the operation wire 68 moves forward or backward with respect to the hand operation unit 90. Since the base end of the sheath 70 is fixed to the hand operation unit 90 and the operation wire 68 is inserted into the sheath 70 so as to be able to advance and retreat, the tip of the operation wire 68 is inserted into the sheath 70 in conjunction with the advance and retreat movement of the slider 93. On the other hand, move forward or backward. As a result, as will be described later, the advancing / retreating portions 67 (FIGS. 2 and 3) of the advanced treatment tool 100 for high-frequency treatment tools are driven to advance / retreat, and the pair of opening / closing portions 10a and 10b are opened / closed.
The axial direction of the rotation axes of the pair of opening / closing portions 10a and 10b is a direction orthogonal to the plate surface of the pair of opening / closing portions 10a and 10b, and when the pair of opening / closing portions 10a and 10b open and close, the pair of opening / closing portions 10a and 10b open and close. Part of the facing surfaces 16 (see FIG. 5) of the opening / closing portions 10a and 10b slide with each other.

図１に示すように、手元操作部９０は給電部９１を備えている。給電部９１は一対の開閉部１０ａ、１０ｂに高周波電流を印加するための端子であり、電源ケーブルを介して高周波電源（不図示）が接続される。高周波処置具用先端処置具１００を構成する一対の開閉部１０ａ、１０ｂ、リンク片６５、６６および進退部６７は、いずれも導電性の金属材料で作製されている。また、操作ワイヤ６８も導電性の金属材料で作製されている。このため、給電部９１に入力された高周波電流は一対の開閉部１０ａ、１０ｂに印加される。 As shown in FIG. 1, the hand operation unit 90 includes a power feeding unit 91. The power feeding unit 91 is a terminal for applying a high frequency current to the pair of opening / closing units 10a and 10b, and a high frequency power supply (not shown) is connected via a power cable. The pair of opening / closing portions 10a and 10b, the link pieces 65 and 66, and the advancing / retreating portion 67 constituting the tip treatment tool 100 for a high-frequency treatment tool are all made of a conductive metal material. The operation wire 68 is also made of a conductive metal material. Therefore, the high frequency current input to the feeding unit 91 is applied to the pair of opening / closing units 10a and 10b.

図２及び図３に示すように、高周波処置具用先端処置具１００は、板状の一対の開閉部１０ａ、１０ｂと、これら一対の開閉部１０ａ、１０ｂを開閉可能に軸支している軸部材６１と、２枚のリンク片６５、６６と、進退部６７と、保持枠８０と、を備えている。
一対の開閉部１０ａ、１０ｂは、操作ワイヤ６８の押し引きにより開閉駆動される。操作ワイヤ６８は、ステンレス鋼などの導電性の金属材料で作製されている。 As shown in FIGS. 2 and 3, the high-frequency treatment tool tip treatment tool 100 has a pair of plate-shaped opening / closing portions 10a and 10b and a shaft that pivotally supports the pair of opening / closing portions 10a and 10b. It includes a member 61, two link pieces 65 and 66, an advancing / retreating portion 67, and a holding frame 80.
The pair of opening / closing portions 10a and 10b are driven to open / close by pushing / pulling the operation wire 68. The operating wire 68 is made of a conductive metal material such as stainless steel.

進退部６７は操作ワイヤ６８の先端に一体に連結されている。進退部６７には軸部材６４により２枚のリンク片６５、６６が回動可能に連結されている。さらに、リンク片６５には軸部材６３により一方の開閉部１０ａの基端片２０が回動可能に連結され、リンク片６６には軸部材６２により他方の開閉部１０ｂの基端片２０が回動可能に連結されている。
各軸部材６２、６３、６４の軸方向は、軸部材６１の軸方向に対して平行な方向である。
一対の開閉部１０ａ、１０ｂおよびリンク片６５、６６は、図２及び図３に示す平面内（軸部材６１の軸方向に対して直交する平面内）で相対的に回動する。
一対の開閉部１０ａ、１０ｂの基端片２０と、リンク片６５、６６とにより菱形の四節リンクが構成されている。
なお、軸部材６２、６３は、軸部材６４よりも先端側に位置しており、軸部材６１は、軸部材６２、６３よりも先端側に位置している。 The advancing / retreating portion 67 is integrally connected to the tip of the operation wire 68. Two link pieces 65 and 66 are rotatably connected to the advancing / retreating portion 67 by a shaft member 64. Further, the base end piece 20 of one opening / closing portion 10a is rotatably connected to the link piece 65 by the shaft member 63, and the base end piece 20 of the other opening / closing portion 10b is rotated by the shaft member 62 to the link piece 66. It is movably connected.
The axial direction of each of the shaft members 62, 63, 64 is a direction parallel to the axial direction of the shaft member 61.
The pair of opening / closing portions 10a and 10b and the link pieces 65 and 66 rotate relatively in the plane shown in FIGS. 2 and 3 (in the plane orthogonal to the axial direction of the shaft member 61).
The base end pieces 20 of the pair of opening / closing portions 10a and 10b and the link pieces 65 and 66 form a rhombic four-node link.
The shaft members 62 and 63 are located closer to the tip side than the shaft member 64, and the shaft member 61 is located closer to the tip side than the shaft members 62 and 63.

保持枠８０はシース７０の先端に固定されている。
保持枠８０は、シース７０の先端に固定されている基端部８１と、基端部８１から先端側に突出している一対のブラケット８２と、を備えている。
ブラケット８２は、例えば板状に形成されている。
一対の開閉部１０ａ、１０ｂは、一対のブラケット８２の先端部に対して、軸部材６１により軸支されている。
一対のブラケット８２どうしの間隙において、一対の開閉部１０ａ、１０ｂの基端片２０と、リンク片６５、６６がそれぞれ回転可能となっているとともに、進退部６７においてシース７０から先端側に突出している部分が進退可能となっている。 The holding frame 80 is fixed to the tip of the sheath 70.
The holding frame 80 includes a base end portion 81 fixed to the tip end of the sheath 70, and a pair of brackets 82 protruding toward the tip end side from the base end portion 81.
The bracket 82 is formed in a plate shape, for example.
The pair of opening / closing portions 10a and 10b are pivotally supported by a shaft member 61 with respect to the tip portions of the pair of brackets 82.
In the gap between the pair of brackets 82, the base end pieces 20 of the pair of opening / closing portions 10a and 10b and the link pieces 65 and 66 are rotatable, respectively, and the advancing / retreating portions 67 project to the tip side from the sheath 70. It is possible to move forward and backward in the part where it is.

このように、高周波処置具用先端処置具１００は、一対の開閉部１０ａ、１０ｂの基端部を回転軸（軸部材６１）の軸方向における両側から挟持しているとともに回転軸において軸支している一対のブラケット８２を備えている。 As described above, the tip treatment tool 100 for high-frequency treatment tools sandwiches the base end portions of the pair of opening / closing portions 10a and 10b from both sides in the axial direction of the rotation shaft (shaft member 61) and supports the rotation shaft. It is provided with a pair of brackets 82.

図２に示すように、操作ワイヤ６８および進退部６７が基端側（図２における右方）に牽引されると、一対の開閉部１０ａ、１０ｂが閉状態となる。逆に、図３に示すように、操作ワイヤ６８および進退部６７が先端側（図３における左方）に押し出されると、一対の開閉部１０ａ、１０ｂが開状態となる。 As shown in FIG. 2, when the operation wire 68 and the advancing / retreating portion 67 are pulled toward the base end side (to the right in FIG. 2), the pair of opening / closing portions 10a and 10b are closed. On the contrary, as shown in FIG. 3, when the operation wire 68 and the advancing / retreating portion 67 are pushed out to the tip end side (left side in FIG. 3), the pair of opening / closing portions 10a and 10b are opened.

一対の開閉部１０ａ、１０ｂの各々は、軸部材６１の近傍において回動面内で浅く屈曲する略Ｌ字状（すなわち鎌形状）をなしている。基端片２０は、一対の開閉部１０ａ、１０ｂの各々において、軸部材６１よりも基端側の部分である。一方、一対の開閉部１０ａ、１０ｂの各々において、軸部材６１よりも先端側の部分を、先端片３０と称する。 Each of the pair of opening / closing portions 10a and 10b has a substantially L-shape (that is, a sickle shape) that bends shallowly in the rotation surface in the vicinity of the shaft member 61. The base end piece 20 is a portion on the base end side of the shaft member 61 in each of the pair of opening / closing portions 10a and 10b. On the other hand, in each of the pair of opening / closing portions 10a and 10b, the portion on the tip end side of the shaft member 61 is referred to as a tip piece 30.

一対の開閉部１０ａ、１０ｂの形状は、互いに同一であってもよいし、互いに異なっていてもよい。本実施形態の場合、一対の開閉部１０ａ、１０ｂは互いに同一形状である。 The shapes of the pair of opening / closing portions 10a and 10b may be the same as each other or may be different from each other. In the case of this embodiment, the pair of opening / closing portions 10a and 10b have the same shape.

開閉部１０ａ、１０ｂの各々の先端片３０の先端には、先端爪部４０が形成されている。先端爪部４０は、閉じ方向に突出している。閉じ方向とは一対の開閉部１０ａ、１０ｂが閉じる方向、すなわち一方の開閉部１０ａから他方の開閉部１０ｂに向かう方向、及び、他方の開閉部１０ｂから一方の開閉部１０ａに向かう方向である。また、一対の開閉部１０ａ、１０ｂが開く方向を開き方向と呼称する。
先端爪部４０は、生体組織に食い込む突起である。
先端片３０において先端爪部４０よりも基端側の部分における閉じ方向側の端縁（エッジ）に沿って、刃部５０が形成されている。
一対の開閉部１０ａ、１０ｂの先端爪部４０により生体組織を抱えるように保持して生体組織の脱落を防止した状態で、一対の開閉部１０ａ、１０ｂの刃部５０により生体組織を切開することができるようになっている。 A tip claw portion 40 is formed at the tip of each tip piece 30 of the opening / closing portions 10a and 10b. The tip claw portion 40 projects in the closing direction. The closing direction is a direction in which the pair of opening / closing portions 10a and 10b are closed, that is, a direction from one opening / closing portion 10a toward the other opening / closing portion 10b, and a direction from the other opening / closing portion 10b toward one opening / closing portion 10a. Further, the direction in which the pair of opening / closing portions 10a and 10b are opened is referred to as an opening direction.
The tip claw portion 40 is a protrusion that bites into a living tissue.
In the tip piece 30, the blade portion 50 is formed along the edge on the closing direction side in the portion on the base end side of the tip claw portion 40.
The living tissue is incised by the blades 50 of the pair of opening / closing portions 10a and 10b in a state where the living tissue is held so as to be held by the tip claw portions 40 of the pair of opening / closing portions 10a and 10b to prevent the living tissue from falling off. Can be done.

一対の開閉部１０ａ、１０ｂの各々の表面には絶縁性被膜１２（図２、図３）が形成されている。絶縁性被膜１２は、少なくとも、先端片３０の表面のうち、電極５２の形成領域を除く全体に形成されている。
絶縁性被膜１２は、たとえばフッ素樹脂などの絶縁性材料を開閉部１０ａ、１０ｂの表面にコーティングして形成することができる。
絶縁性被膜１２の膜厚は、先端処置部１０において最も幅広の部分における膜厚が、局部的に、他部における膜厚よりも厚くなっていてもよい。このようにすることにより、先端処置部１０が内視鏡３００の鉗子孔（不図示）の周壁に対してほぼ点接触して進退する際にも、先端処置部１０において最も幅広の部分における絶縁性被膜１２の剥離を抑制できて、当該部分における金属素地の露出を抑制できる。
電極５２は、刃部５０において絶縁性被膜１２から露出した線状の部分である。一対の開閉部１０ａ、１０ｂは、給電部９１から同位相の高周波電圧が印加されてモノポーラ型の高周波電極となる。一対の開閉部１０ａ、１０ｂで生体組織を把持した状態で高周波電流を一対の開閉部１０ａ、１０ｂに印加することにより、生体組織は焼灼されて切開される。なお、本実施形態に代えて、一対の開閉部１０ａ、１０ｂの一方をアクティブ電極とし、他方をリターン電極とするバイポーラ型の高周波処置具２００としてもよい。 An insulating coating 12 (FIGS. 2 and 3) is formed on the surface of each of the pair of opening / closing portions 10a and 10b. The insulating coating 12 is formed on at least the entire surface of the tip piece 30 except for the region where the electrode 52 is formed.
The insulating coating 12 can be formed by coating the surfaces of the opening / closing portions 10a and 10b with an insulating material such as fluororesin.
As for the film thickness of the insulating coating 12, the film thickness in the widest portion of the tip treatment portion 10 may be locally thicker than the film thickness in the other portion. By doing so, even when the tip treatment portion 10 makes a substantially point contact with the peripheral wall of the forceps hole (not shown) of the endoscope 300 and advances and retreats, the insulation in the widest portion of the tip treatment portion 10 is provided. The peeling of the sex film 12 can be suppressed, and the exposure of the metal substrate in the portion can be suppressed.
The electrode 52 is a linear portion of the blade portion 50 exposed from the insulating coating 12. The pair of opening / closing portions 10a and 10b are monopolar type high frequency electrodes to which a high frequency voltage having the same phase is applied from the feeding portion 91. By applying a high-frequency current to the pair of opening / closing portions 10a and 10b while holding the living tissue with the pair of opening / closing portions 10a and 10b, the living tissue is cauterized and incised. Instead of this embodiment, a bipolar type high frequency treatment tool 200 may be used in which one of the pair of opening / closing portions 10a and 10b is used as an active electrode and the other is used as a return electrode.

刃部５０の形状は特に限定されないが、本実施形態の場合、刃部５０には、高段部５４と、高段部５４よりも開き方向側に向けて窪んだ切欠形状の低段部５５と、が形成されている。
電極５２は、例えば、先端爪部４０における基端側の縁辺、低段部５５、及び、高段部５４の基端部に位置する電極基端位置５２ａに亘って、連続的に形成されている。 The shape of the blade portion 50 is not particularly limited, but in the case of the present embodiment, the blade portion 50 has a high step portion 54 and a notched low step portion 55 recessed toward the opening direction side of the high step portion 54. And are formed.
The electrode 52 is continuously formed, for example, over the edge on the proximal end side of the tip claw portion 40, the low step portion 55, and the electrode proximal position 52a located at the proximal end portion of the high step portion 54. There is.

本実施形態の場合、「先端処置部１０の先端側の部分」、すなわち「一対の開閉部１０ａ、１０ｂが閉じた状態で、上記回転軸の軸方向に視たときの形状が、先端から基端に向けて幅広になった後、幅狭になる形状の部分」は、電極５２の形成領域の基端（電極基端位置５２ａ）よりも先端側の部分である。 In the case of the present embodiment, the "part on the tip side of the tip treatment portion 10", that is, the shape when viewed in the axial direction of the rotation axis with the pair of opening / closing portions 10a and 10b closed is based on the tip. The portion having a shape that widens toward the end and then narrows is a portion on the distal end side of the proximal end (electrode proximal end position 52a) of the forming region of the electrode 52.

より詳細には、本実施形態の場合、「先端処置部１０の先端側の部分」は、先端処置部１０の先基端方向における中間位置Ｃ１（図２）よりも先端側の部分である。つまり、一対の開閉部１０ａ、１０ｂが閉じた状態で先端処置部１０を先基端方向に二分したうちの先端側の部分が、先端から基端に向けて幅広になった後、幅狭になる形状となっている。 More specifically, in the case of the present embodiment, the "part on the tip end side of the tip treatment portion 10" is a portion on the tip end side of the intermediate position C1 (FIG. 2) in the tip base end direction of the tip treatment portion 10. That is, in a state where the pair of opening / closing portions 10a and 10b are closed, the portion on the tip end side of the tip treatment portion 10 divided in the direction of the tip end end becomes wider from the tip toward the base end and then becomes narrower. It has the shape of.

より詳細には、「先端処置部１０の先端側の部分」は、先端から基端に向けて図２の上方及び下方の双方に向けて徐々に幅広になった後、徐々に幅狭になる形状である。
より詳細には、先端処置部１０の全体が、先端から基端に向けて図２の上方及び下方の双方に向けて徐々に幅広になった後、徐々に幅狭になる形状である。つまり、先端処置部１０において、図２の上下方向に最も幅広の部分よりも基端側の部分は、徐々に単調に幅狭となっている。 More specifically, the "tip-side portion of the tip treatment portion 10" gradually widens from the tip to the base end toward both the upper and lower sides of FIG. 2, and then gradually narrows. It is a shape.
More specifically, the entire tip treatment portion 10 has a shape in which the width gradually widens toward both the upper side and the lower side of FIG. 2 from the tip end to the base end, and then gradually narrows. That is, in the tip treatment portion 10, the portion on the proximal end side of the portion in the vertical direction of FIG. 2 is gradually narrowed monotonously.

一対の開閉部１０ａ、１０ｂの少なくとも一方には、ストッパー部１１が形成されている。一対の開閉部１０ａ、１０ｂの閉動作は、ストッパー部１１が他方の開閉部（開閉部１０ａ又は開閉部１０ｂ）の刃部５０に当接することで規制されるようになっている。
本実施形態の場合、一対の開閉部１０ａ、１０ｂの各々にストッパー部１１が形成されており、開閉部１０ａのストッパー部１１が開閉部１０ｂの刃部５０に当接するとともに、開閉部１０ｂのストッパー部１１が開閉部１０ａの刃部５０に当接することで、一対の開閉部１０ａ、１０ｂの閉動作が規制される。
ストッパー部１１において、他方の開閉部（開閉部１０ａ又は１０ｂ）側を向く部位は、平坦面１１ａとなっている。 A stopper portion 11 is formed on at least one of the pair of opening / closing portions 10a and 10b. The closing operation of the pair of opening / closing portions 10a and 10b is regulated by the stopper portion 11 coming into contact with the blade portion 50 of the other opening / closing portion (opening / closing portion 10a or opening / closing portion 10b).
In the case of the present embodiment, the stopper portion 11 is formed in each of the pair of opening / closing portions 10a and 10b, and the stopper portion 11 of the opening / closing portion 10a comes into contact with the blade portion 50 of the opening / closing portion 10b and the stopper of the opening / closing portion 10b. When the portion 11 comes into contact with the blade portion 50 of the opening / closing portion 10a, the closing operation of the pair of opening / closing portions 10a and 10b is restricted.
In the stopper portion 11, the portion facing the other opening / closing portion (opening / closing portion 10a or 10b) is a flat surface 11a.

図２から図４に示すように、基端片２０の外側面には段差部２３が形成されている。基端片２０において段差部２３よりも基端側の部位は、段差部２３よりも先端側の部位よりも薄くなっている。
図４に示すように、基端片２０において段差部２３よりも基端側の部位と先端側の部位との厚みの差は、リンク片６５、６６の厚みよりも若干大きい程度に設定されているか、又は、リンク片６５、６６の厚みと同等に設定されている。 As shown in FIGS. 2 to 4, a step portion 23 is formed on the outer surface of the base end piece 20. In the base end piece 20, the portion on the proximal end side of the step portion 23 is thinner than the portion on the distal end side of the step portion 23.
As shown in FIG. 4, the difference in thickness between the portion on the proximal end side and the portion on the distal end side of the step portion 23 in the proximal end piece 20 is set to be slightly larger than the thickness of the link pieces 65 and 66. Or, it is set to be the same as the thickness of the link pieces 65 and 66.

図２に示すように、一対の開閉部１０ａ、１０ｂが閉じた状態で、先基端方向と軸方向との双方に対して直交する方向（つまり図２における上下方向）において、先端処置部１０の基端部１９の寸法が、ブラケット８２の寸法よりも小さい。つまり、図２に示す寸法Ｗ１が寸法Ｗ２よりも小さい。
このような構成によって、内視鏡３００の先端から先端処置部１０を突出させ、一対の開閉部１０ａ、１０ｂを開いて処置を行なう際に、内視鏡３００の先端に対する一対の開閉部１０ａ、１０ｂの干渉をより一層抑制することができる。
同様に、一対の開閉部１０ａ、１０ｂどうしを開いた状態で回転操作する場合に、一対の開閉部１０ａ、１０ｂと、これら一対の開閉部１０ａ、１０ｂの背後に位置する生体組織と、の干渉をより一層抑制できる。 As shown in FIG. 2, in a state where the pair of opening / closing portions 10a and 10b are closed, the tip treatment portion 10 is in a direction orthogonal to both the tip end direction and the axial direction (that is, the vertical direction in FIG. 2). The dimension of the base end portion 19 is smaller than the dimension of the bracket 82. That is, the dimension W1 shown in FIG. 2 is smaller than the dimension W2.
With such a configuration, when the tip treatment portion 10 is projected from the tip of the endoscope 300 and the pair of opening / closing portions 10a and 10b are opened for treatment, the pair of opening / closing portions 10a with respect to the tip of the endoscope 300, The interference of 10b can be further suppressed.
Similarly, when the pair of opening / closing portions 10a and 10b are rotated while being opened, the pair of opening / closing portions 10a and 10b interfere with the living tissue located behind the pair of opening / closing portions 10a and 10b. Can be further suppressed.

図４に示すように、保持枠８０の一対のブラケット８２は、一対の開閉部１０ａ、１０ｂの基端片２０を一対の開閉部１０ａ、１０ｂの回転軸（軸部材６１）の軸方向における両側から挟持しているとともに、当該回転軸において軸支している。一対のブラケット８２は、当該ブラケット８２の先端部において基端片２０を挟持及び軸支している。
一対のブラケット８２の各々の先端部において、一対のブラケット８２の各々の対向面８２ａに対する裏面である外面８２ｂが平坦に形成されている。しかも、一対のブラケット８２の各々の先端部の外面８２ｂどうしの距離が、ブラケット８２の基端部の外面どうしの距離よりも小さい。つまり、ブラケット８２の先端部は、外面側が削られて平坦となったような形状となっている。
このため、ブラケット８２と生体組織や鉗子孔の周壁との干渉を抑制することができる。また、ブラケット８２に対する塗装が容易であるという効果も得られる。 As shown in FIG. 4, the pair of brackets 82 of the holding frame 80 has the base end pieces 20 of the pair of opening / closing portions 10a and 10b on both sides of the pair of opening / closing portions 10a and 10b in the axial direction. It is sandwiched from the top and is supported by the rotating shaft. The pair of brackets 82 sandwich and pivotally support the base end piece 20 at the tip of the bracket 82.
At the tip of each of the pair of brackets 82, the outer surface 82b, which is the back surface of the pair of brackets 82 with respect to the facing surfaces 82a, is formed flat. Moreover, the distance between the outer surfaces 82b of each tip of the pair of brackets 82 is smaller than the distance between the outer surfaces of the base ends of the brackets 82. That is, the tip portion of the bracket 82 has a shape such that the outer surface side is scraped off and becomes flat.
Therefore, it is possible to suppress the interference between the bracket 82 and the biological tissue or the peripheral wall of the forceps hole. Further, the effect that the bracket 82 can be easily painted can be obtained.

ここで、図５に示すように、一対の開閉部１０ａ、１０ｂの開き方向側の縁部１３と外面１４との境界部１５が面取り形状とされている。
これにより、先端処置部１０が内視鏡３００の鉗子孔（不図示）の周壁に対してよりスムーズに滑動できるため、高周波処置具用先端処置具１００を鉗子孔内で前進させる動作をスムーズにすることができる。
境界部１５はＲ面取り形状であることが好ましい。 Here, as shown in FIG. 5, the boundary portion 15 between the edge portion 13 on the opening direction side of the pair of opening / closing portions 10a and 10b and the outer surface 14 is chamfered.
As a result, the tip treatment portion 10 can slide more smoothly with respect to the peripheral wall of the forceps hole (not shown) of the endoscope 300, so that the tip treatment tool 100 for high-frequency treatment tools can be smoothly advanced in the forceps hole. can do.
The boundary portion 15 preferably has an R chamfered shape.

また、一対の開閉部１０ａ、１０ｂの開き方向側の縁部１３と対向面１６との境界部１７も面取り形状とされている。
これにより、先端処置部１０が内視鏡３００の鉗子孔（不図示）の周壁に対してよりスムーズに滑動できるため、高周波処置具用先端処置具１００を鉗子孔内で前進させる動作をスムーズにすることができる。
境界部１７もＲ面取り形状であることが好ましい。 Further, the boundary portion 17 between the edge portion 13 on the opening direction side of the pair of opening / closing portions 10a and 10b and the facing surface 16 is also chamfered.
As a result, the tip treatment portion 10 can slide more smoothly with respect to the peripheral wall of the forceps hole (not shown) of the endoscope 300, so that the tip treatment tool 100 for high-frequency treatment tools can be smoothly advanced in the forceps hole. can do.
The boundary portion 17 also preferably has an R chamfered shape.

以上のような第１実施形態によれば、仮想直線Ｌ１を基準とする高さが、先端爪部４０の高さよりも、刃部５０における電極５２の形成領域（電極形成領域５３）のうち最も高い位置の高さの方が低いことにより、一対の開閉部１０ａ、１０ｂを閉じる際に刃部５０によって生体組織を押し戻す動作が抑制される。このため、一対の開閉部１０ａ、１０ｂを閉じる際に先端爪部４０を速やかに生体組織に食い込ませることができ、一対の開閉部１０ａ、１０ｂによって生体組織をより確実に把持することが可能である。 According to the first embodiment as described above, the height with respect to the virtual straight line L1 is the most in the electrode 52 forming region (electrode forming region 53) in the blade portion 50, rather than the height of the tip claw portion 40. Since the height at the higher position is lower, the action of pushing back the living tissue by the blade portion 50 when closing the pair of opening / closing portions 10a and 10b is suppressed. Therefore, when closing the pair of opening / closing portions 10a and 10b, the tip claw portion 40 can be quickly bitten into the living tissue, and the pair of opening / closing portions 10a and 10b can more reliably grip the living tissue. be.

〔第２実施形態〕
次に、図７から図９を用いて第２実施形態を説明する。
本実施形態に係る高周波処置具２００及び高周波処置具用先端処置具１００は、以下に説明する点で、上記の第１実施形態に係る高周波処置具２００及び高周波処置具用先端処置具１００と相違しており、その他の点では、上記の第１実施形態に係る高周波処置具２００及び高周波処置具用先端処置具１００と同様に構成されている。 [Second Embodiment]
Next, the second embodiment will be described with reference to FIGS. 7 to 9.
The high-frequency treatment tool 200 and the high-frequency treatment tool tip treatment tool 100 according to the present embodiment are different from the high-frequency treatment tool 200 and the high-frequency treatment tool tip treatment tool 100 according to the first embodiment above in that they are described below. In other respects, it is configured in the same manner as the high frequency treatment tool 200 and the advanced treatment tool 100 for high frequency treatment tools according to the first embodiment.

上記の第１実施形態では、一対の開閉部１０ａ、１０ｂの各々が薄板状の剪断鋏部である例を説明したが、本実施形態の場合、一対の開閉部１０ａ、１０ｂはそれぞれ棒状に形成されており、且つ、互いの方を向く対向面５６、５７をそれぞれ備えている。
一対の開閉部１０ａ、１０ｂが閉じた状態で、対向面５６と対向面５７とは一対の開閉部１０ａ、１０ｂの開閉方向において互いに重なり合うようになっている。
一対の開閉部１０ａ、１０ｂは、対向面５６、５７により生体組織を挟持するように構成されている。 In the first embodiment described above, an example in which each of the pair of opening / closing portions 10a and 10b is a thin plate-shaped shear shear portion has been described, but in the case of the present embodiment, the pair of opening / closing portions 10a and 10b are formed in a rod shape, respectively. It is provided with facing surfaces 56 and 57 facing each other, respectively.
With the pair of opening / closing portions 10a and 10b closed, the facing surface 56 and the facing surface 57 overlap each other in the opening / closing direction of the pair of opening / closing portions 10a and 10b.
The pair of opening / closing portions 10a and 10b are configured to sandwich the living tissue by the facing surfaces 56 and 57.

図９に示すように、例えば、開閉部１０ａの幅方向における中央部において、先基端方向に延在する電極５２が形成されている。同様に、図示は省略するが、開閉部１０ｂの幅方向における中央部において、先基端方向に延在する電極５２が形成されている。 As shown in FIG. 9, for example, in the central portion of the opening / closing portion 10a in the width direction, an electrode 52 extending in the tip end direction is formed. Similarly, although not shown, an electrode 52 extending in the tip end direction is formed in the central portion of the opening / closing portion 10b in the width direction.

例えば、開閉部１０ａと開閉部１０ｂとのうち、開閉部１０ａの先端部には先端爪部４０が形成されており、開閉部１０ｂの先端部には先端爪部４０が形成されていない。
開閉部１０ｂは、先端爪部４０を有していない分、開閉部１０ａよりも短く形成されている。図７に示すように一対の開閉部１０ａ、１０ｂが閉じた状態で、開閉部１０ａの先端爪部４０における基端側の面が、開閉部１０ｂの先端面に対して当接又は近接するようになっている。 For example, of the opening / closing portion 10a and the opening / closing portion 10b, the tip claw portion 40 is formed at the tip portion of the opening / closing portion 10a, and the tip claw portion 40 is not formed at the tip portion of the opening / closing portion 10b.
The opening / closing portion 10b is formed shorter than the opening / closing portion 10a because it does not have the tip claw portion 40. As shown in FIG. 7, with the pair of opening / closing portions 10a and 10b closed, the surface on the proximal end side of the tip claw portion 40 of the opening / closing portion 10a is in contact with or close to the tip surface of the opening / closing portion 10b. It has become.

本実施形態の場合も、一対の開閉部１０ａ、１０ｂが閉じた状態で、上記回転軸の軸方向（図７の紙面に対して直交する方向）に視たときの先端処置部１０の先端側の部分の形状が、先端から基端に向けて幅広になった後、幅狭になる形状である。
また、本実施形態の場合も、先端処置部１０の先端側の部分は、電極５２の形成領域の基端よりも先端側の部分である。
また、本実施形態の場合も、先端処置部１０の先端側の部分は、先端処置部１０の先基端方向における中間位置よりも先端側の部分である。 Also in the case of the present embodiment, when the pair of opening / closing portions 10a and 10b are closed and viewed in the axial direction of the rotation axis (direction orthogonal to the paper surface of FIG. 7), the tip end side of the tip treatment portion 10 The shape of the portion is widened from the tip to the base and then narrowed.
Further, also in the case of the present embodiment, the portion on the tip end side of the tip treatment portion 10 is a portion on the tip end side of the base end of the forming region of the electrode 52.
Further, also in the case of the present embodiment, the portion on the tip end side of the tip treatment portion 10 is a portion on the tip end side of the intermediate position in the tip base end direction of the tip treatment portion 10.

本実施形態によっても、第１実施形態と同様の効果が得られる。 The same effect as that of the first embodiment can be obtained by this embodiment as well.

以上、図面を参照して各実施形態を説明したが、これらは本発明の例示であり、上記以外の様々な構成を採用することもできる。
また、上記の各実施形態は、本発明の主旨を逸脱しない範囲で、適宜に組み合わせることができる。 Although each embodiment has been described above with reference to the drawings, these are examples of the present invention, and various configurations other than the above can be adopted.
In addition, each of the above embodiments can be appropriately combined as long as the gist of the present invention is not deviated.

本実施形態は以下の技術思想を包含する。
（１）医療用の高周波処置具の先端部に設けられ、内視鏡の鉗子孔に挿入して用いられて生体組織を切開する高周波処置具用先端処置具であって、
それぞれライン状の形状の電極が形成され、共通の回転軸において軸支されて相互に開閉可能となっており、前記生体組織を剪断又は挟持して高周波切除する一対の開閉部により構成された先端処置部を備え、
前記一対の開閉部が閉じた状態で、前記回転軸の軸方向に視たときの前記先端処置部の先端側の部分の形状が、先端から基端に向けて幅広になった後、幅狭になる形状である高周波処置具用先端処置具。
（２）前記先端処置部の前記先端側の部分は、前記電極の形成領域の基端よりも先端側の部分である（１）に記載の高周波処置具用先端処置具。
（３）前記先端処置部の前記先端側の部分は、前記先端処置部の先基端方向における中間位置よりも先端側の部分である（１）又は（２）に記載の高周波処置具用先端処置具。
（４）前記一対の開閉部の基端部を前記回転軸の軸方向における両側から挟持しているとともに前記回転軸において軸支している一対のブラケットを備え、
前記一対の開閉部が閉じた状態で、先基端方向と前記軸方向との双方に対して直交する方向において、前記先端処置部の基端部の寸法が、前記ブラケットの寸法よりも小さい（１）から（３）のいずれか一項に記載の高周波処置具用先端処置具。
（５）前記一対の開閉部の開き方向側の縁部と外面との境界部が面取り形状とされている（１）から（４）のいずれか一項に記載の高周波処置具用先端処置具。
（６）前記一対の開閉部の基端部を前記回転軸の軸方向における両側から挟持しているとともに前記回転軸において軸支している一対のブラケットを備え、
前記一対のブラケットは、当該ブラケットの先端部において前記一対の開閉部を挟持及び軸支しており、
前記一対のブラケットの各々の先端部において、前記一対のブラケットの各々の対向面に対する裏面である外面が平坦に形成されており、
且つ、
前記一対のブラケットの各々の先端部の外面どうしの距離が、前記ブラケットの基端部の外面どうしの距離よりも小さい（１）から（５）のいずれか一項に記載の高周波処置具用先端処置具。
（７）（１）から（６）のいずれか一項に記載の高周波処置具用先端処置具を先端部に有し、基端側には、前記一対の開閉部の開閉操作を行うための操作部を有する医療用の高周波処置具。 This embodiment includes the following technical ideas.
(1) A tip treatment tool for a high-frequency treatment tool provided at the tip of a high-frequency treatment tool for medical use and used by inserting it into a forceps hole of an endoscope to make an incision in a living tissue.
Each line-shaped electrode is formed, and it is pivotally supported on a common rotation axis so that it can be opened and closed mutually. Equipped with a treatment section
With the pair of opening / closing portions closed, the shape of the tip-side portion of the tip-treated portion when viewed in the axial direction of the rotation axis becomes wider from the tip to the base end and then narrows. Tip treatment tool for high frequency treatment tool that has a shape that becomes.
(2) The tip treatment tool for a high-frequency treatment tool according to (1), wherein the tip side portion of the tip treatment portion is a portion on the tip side of the base end of the electrode forming region.
(3) The tip of the high-frequency treatment tool according to (1) or (2), wherein the tip-side portion of the tip-treatment portion is a portion on the tip-side side of the intermediate position in the tip-base end direction of the tip-treatment portion. Treatment tool.
(4) A pair of brackets that sandwich the base end portions of the pair of opening / closing portions from both sides in the axial direction of the rotating shaft and are axially supported by the rotating shaft are provided.
With the pair of opening / closing portions closed, the dimension of the proximal end portion of the tip treatment portion is smaller than the dimension of the bracket in the direction orthogonal to both the tip proximal end direction and the axial direction ( The tip treatment tool for a high frequency treatment tool according to any one of 1) to (3).
(5) The tip treatment tool for high-frequency treatment tools according to any one of (1) to (4), wherein the boundary portion between the edge portion on the opening direction side and the outer surface of the pair of opening / closing portions has a chamfered shape. ..
(6) A pair of brackets that sandwich the base end portions of the pair of opening / closing portions from both sides in the axial direction of the rotating shaft and are axially supported by the rotating shaft are provided.
The pair of brackets sandwich and pivotally support the pair of opening / closing portions at the tip of the bracket.
At the tip of each of the pair of brackets, the outer surface which is the back surface of the pair of brackets with respect to the facing surface is formed flat.
and,
The tip for a high frequency treatment tool according to any one of (1) to (5), wherein the distance between the outer surfaces of the tips of each of the pair of brackets is smaller than the distance between the outer surfaces of the base ends of the brackets. Treatment tool.
(7) The tip treatment tool for high-frequency treatment tool according to any one of (1) to (6) is provided at the tip portion, and the pair of opening / closing portions are opened / closed on the proximal end side. A medical high frequency treatment tool having an operation unit.

１０先端処置部
１０ａ、１０ｂ開閉部
１１ストッパー部
１１ａ平坦面
１２絶縁性被膜
１３縁部
１４外面
１５境界部
１６対向面
１７境界部
１９基端部
２０基端片
２３段差部
３０先端片
４０先端爪部
５０刃部
５２電極
５２ａ電極基端位置
５４高段部
５５低段部
５６、５７対向面
６１、６２、６３、６４軸部材
６１ａ軸中心
６５、６６リンク片
６７進退部
６８操作ワイヤ
７０シース
７１コイル
７２絶縁性被膜
８０保持枠
８１基端部
８２ブラケット
８２ａ対向面
８２ｂ外面
９０手元操作部（操作部）
９１給電部
９２指掛リング
９３スライダ
９４回転操作部
９５軸部
１００高周波処置具用先端処置具
２００医療用の高周波処置具
３００内視鏡
３１０フード 10 Tip treatment part 10a, 10b Opening and closing part 11 Stopper part 11a Flat surface 12 Insulating coating 13 Edge part 14 Outer surface 15 Boundary part 16 Opposing surface 17 Boundary part 19 Base end part 20 Base end piece 23 Step part 30 Tip piece 40 Tip claw Part 50 Blade part 52 Electrode 52a Electrode base end position 54 High step part 55 Low step part 56, 57 Facing surface 61, 62, 63, 64 Shaft member 61a Shaft center 65, 66 Link piece 67 Advance / retreat part 68 Operation wire 70 Sheath 71 Coil 72 Insulation coating 80 Holding frame 81 Base end 82 Bracket 82a Facing surface 82b Outer surface 90 Hand operation unit (operation unit)
91 Power supply unit 92 Finger hook ring 93 Slider 94 Rotation operation unit 95 Shaft unit 100 Tip treatment tool for high frequency treatment tool 200 High frequency treatment tool for medical use 300 Endoscope 310 Hood

Claims

A tip treatment tool for high-frequency treatment tools that is provided at the tip of a high-frequency treatment tool for medical use and is used by inserting it into the forceps hole of an endoscope to make an incision in a living tissue.
Each line-shaped electrode is formed, and it is pivotally supported on a common rotation axis so that it can be opened and closed mutually. Equipped with a treatment section
With the pair of opening / closing portions closed, the shape of the tip-side portion of the tip-treated portion when viewed in the axial direction of the rotation axis becomes wider from the tip to the proximal end and then narrows. It is a shape that becomes
The tip treatment tool for a high frequency treatment tool , wherein the tip treatment portion is a portion on the tip side of the tip treatment portion in the intermediate position in the tip base end direction of the tip treatment portion .

The tip treatment tool for a high frequency treatment tool according to claim 1, wherein the portion on the tip side of the tip treatment portion is a portion on the tip side of the base end of the electrode forming region.

A pair of brackets that sandwich the base end portions of the pair of opening / closing portions from both sides in the axial direction of the rotating shaft and are axially supported by the rotating shaft are provided.
A claim in which the dimension of the proximal end portion of the tip treatment portion is smaller than the dimension of the bracket in a direction orthogonal to both the tip proximal end direction and the axial direction with the pair of opening / closing portions closed. Item 2. The tip treatment tool for a high frequency treatment tool according to Item 1 or 2 .

The tip treatment tool for a high-frequency treatment tool according to any one of claims 1 to 3 , wherein the boundary portion between the edge portion on the opening direction side and the outer surface of the pair of opening / closing portions has a chamfered shape.

A pair of brackets that sandwich the base end portions of the pair of opening / closing portions from both sides in the axial direction of the rotating shaft and are axially supported by the rotating shaft are provided.
The pair of brackets sandwich and pivotally support the pair of opening / closing portions at the tip of the bracket.
At the tip of each of the pair of brackets, the outer surface which is the back surface of the pair of brackets with respect to the facing surface is formed flat.
and,
The tip treatment tool for a high frequency treatment tool according to any one of claims 1 to 4 , wherein the distance between the outer surfaces of the tips of each of the pair of brackets is smaller than the distance between the outer surfaces of the base ends of the brackets. ..

Medical treatment that has the tip treatment tool for high-frequency treatment tool according to any one of claims 1 to 5 at the tip portion, and has an operation unit for opening and closing the pair of opening / closing portions on the proximal end side. High frequency treatment tool for.