JP7101439B2 - Treatment tool for basket-type endoscope equipment - Google Patents

Description

The present invention relates to a treatment tool for a basket-type endoscope device, which is inserted into a body cavity and has a treatment portion for sandwiching and crushing a foreign substance such as a stone in the body cavity by a basket made of a plurality of elastic wires, and particularly, a deformation of the basket. The present invention relates to a treatment tool for a basket-type endoscope device that can prevent the above.

Generally, for the collection and crushing of foreign substances such as calculus in the body cavity, a basket gripper having a flexible sheath in which a basket-shaped expandable and contractible basket portion is housed in a cylinder is inserted into the endoscope channel and inside the body cavity. The treatment is performed by bringing the basket closer to a foreign substance such as a calculus and projecting the basket portion from the tip of the flexible sheath to capture the calculus. This basket gripper has a stretchable basket portion attached to the tip of an operation wire inserted into the flexible sheath, and protrudes from the tip of the flexible sheath from a state in which the basket portion is positioned inside the tip of the flexible sheath. The calculus or the like is taken into the basket portion by being expanded, and the operation wire is pulled and contracted by the operation portion to crush or grip the calculus or the like and pull it out. The following Patent Document 1 is mentioned as a document describing a technique relating to such a basket gripper.

In Patent Document 1, the endoscope is removed from the body while the basket wire of the calculus crushing device and the basket forceps for stone collection is left in the body, the basket wire is covered with a coil sheath under fluoroscopy, and the basket wire is covered by the operation unit. The technique of winding up and crushing stones is described.

Japanese Unexamined Patent Publication No. 2002-11016

Although the treatment tool for an endoscopic device described in the above-mentioned patent document can crush stones by a strong crushing force and can quickly insert a coil sheath, when the basket wire is wound up and crushed. It could lead to the problem that the basket wire is likely to be deformed.

In view of such problems, it is an object of the present invention to provide a treatment tool for an endoscope device capable of preventing deformation of a basket wire when crushing a calculus.

In order to achieve the above object, the treatment tool for an endoscope device according to the present invention includes a long cylindrical flexible sheath, an operation wire freely inserted into the cylinder of the flexible sheath, and the operation wire. A basket portion provided at the tip of the operation wire and formed so that a plurality of basket wires having a predetermined diameter are elastically reduced or expanded, and a basket portion attached to the tip of the flexible sheath to provide the basket portion. In a treatment tool for a basket-type endoscope device that includes a tip fitting for inserting the operated wire and the basket wire is reduced in diameter to capture stones and the like, the tip fitting is a hard material having a substantially cylindrical shape. It is composed of an annular portion that fits into the tip of the flexible sheath, and a plurality of protrusions that project at equal intervals in the width of the annular portion in the basket portion direction to accommodate the basket wire. When the height of the plurality of protrusions is set to about 2 to 3 times the predetermined diameter of the basket wire and the diameter of the basket wire is reduced to capture the stone or the like, the lower surface of the stone or the like has the protrusion. The first feature is that the upper end of the plurality of protrusions is formed so as to be in contact with the upper end of the portion and the upper ends of the plurality of protrusions are formed so as to face the cylindrical center of the tip metal fitting.

The second feature of the present invention is that, in the treatment tool for a basket-type endoscope device of the first feature, the plurality of protrusions are provided at least as many as the number of basket wires. Or, in the treatment tool for the basket-type endoscope device of the feature 2 , a vertically long guide groove is engraved in the axial direction at a position facing the notch formed between the protrusions of the tip metal fitting, and the tip thereof. The third feature is that a stopper that extends and fits in the axial direction of the metal fitting is provided. In the treatment tool for a basket-type endoscope device of the third feature, the vertically long guide groove of the stopper is on the tip side. The fourth feature is that the width on the flexible sheath side is wider than that of the third or fourth feature, and the stopper is the stopper in the treatment tool for the basket-type endoscope device of the third or fourth feature. The fifth feature is that an annular locking portion that fits in the axial direction of the tip metal fitting and defines the dimension protruding from the tip metal fitting is provided in the circumferential direction, and is one of the above- mentioned third to fifth features. The sixth feature of the treatment tool for a basket-type endoscope device is that the stopper is provided with a guide hole from which the end of the vertically long guide groove on the flexible sheath side is removed.

In the treatment tool for an endoscope device according to the present invention, a basket is provided by providing a tip fitting composed of a ring portion and a plurality of protrusions protruding at equal intervals in the basket portion direction of the ring portion at the tip of the flexible sheath. The root portion of the wire is released in the circumferential direction to prevent the force on the lower end side of the calculus from being applied to the basket wire, and the basket wire can be prevented from being damaged or deformed.

The figure which shows the whole structure of the treatment tool for an endoscope apparatus by an Example of this invention. The figure which shows the tip metal fitting of the treatment tool for an endoscope apparatus according to Example 1 of this invention. The figure for demonstrating the principle by Example 1 of this invention. The figure which shows the tip metal fitting and the stopper of the treatment tool for an endoscope apparatus according to Example 2 of this invention. The figure which shows the tip metal fitting of the treatment tool for an endoscope apparatus according to Example 3 of this invention. The figure which shows the stopper of the treatment tool for an endoscope apparatus according to Examples 4 and 6 of this invention. The figure which shows the stopper of the treatment tool for an endoscope apparatus according to Example 5 of this invention. The figure for demonstrating the operation example of the treatment tool for an endoscope apparatus to which this invention is applied.

Hereinafter, examples of the treatment tool for the endoscope device according to the present invention will be described in detail with reference to the drawings. First, the overall structure of the treatment tool for the endoscope device according to the embodiment of the present invention will be described.

As shown in FIG. 1, the treatment tool for an endoscopic device according to this embodiment has a long cylindrical flexible sheath 2 made of a resin, a coil, or the like to which an operation portion 10 is attached to a rear end, and this flexibility. An operation wire 3 that is freely inserted into the sheath 2, a tip fitting 20 that is a feature of the present invention and is made of a hard metal material arranged at the tip of the flexible sheath 2, and a tip of the operation wire 3. It is provided with a basket portion 4 for crushing foreign matter, which is a treatment portion that is connected to the flexible sheath 2 and can be sunk from the inside of the flexible sheath 2 by the advance / retreat operation of the operation wire 3. As will be described later, the tip metal fitting 20 in the drawing is shown so that the annular portion has a cross section and the wire penetrating portion 20b has a rear portion so that it does not have a cross section.

The operation unit 10 penetrates the grip portion 14 attached to the rear end of the operation wire 3 via the operation pipe 12 and the operation pipe 12 of the grip portion 14 attached to the operation wire 3, and the water supply port 13 opens. The operation unit main body 11 is provided so as to move the operation wire 3 with respect to the flexible sheath 2 by moving the grip portion 14 forward and backward. The water supply port 13 is configured such that the inner end portion communicates with the in-cylinder space of the operation unit main body 11 and an injection or the like (not shown) can be attached so that the chemical solution or the like can be sent into the flexible sheath 2.

The basket portion 4 includes a plurality of (four in this embodiment) basket wires 8 made of stranded wires, a tip tip 6 for fixing the tips of the basket wires 8 together, and a rear end of the basket wires 8. The treatment portion is formed so that the plurality of basket wires 8 elastically contract or expand at intervals, and are composed of a rear end tip 7 for collectively fixing the cage wires.

The basket portion 4 is self-urged so that each basket wire 8 is curved and bulges outward, and the basket wire 8 is arranged in a three-dimensional line-symmetrical relationship with the central axis of the basket portion 4 as the center of symmetry. The diameter of the flexible sheath 2 is reduced, and when it protrudes from the tip of the flexible sheath 2, it expands and expands by self-biasing to form a substantially cage shape.

The treatment tool for the endoscope device, which is the basket gripping tool according to the present embodiment configured as described above, is inserted into the body cavity of the patient through the channel of the endoscope device previously inserted into the body cavity of the patient and is to be collected. It is used to crush stones, which are objects, and an example of this procedure will be described with reference to FIG.

As shown in FIG. 6A, the treatment of this basket-type endoscope device is flexible in a state in which a doctor pulls an operation wire and pulls the basket portion at the tip into the inside to reduce the diameter. The step of inserting the sheath 2 into the bile duct 22 in the papilla 210 of the duodenum, and then, as shown in FIG. 6 (b), push out the operation wire to open the basket portion 4 from the tip of the flexible sheath 2 and deeper than the calculus 230. A step of moving the calculus to the position of, then a step of projecting the operation wire and pulling it into the flexible sheath 2 to capture the calculus 230 in the gap of the basket portion 4, as shown in FIG. 6 (c), and further, FIG. As shown in (d), the basket portion 4 is further pulled into the flexible sheath 2, sandwiched between the tip fitting at the tip of the flexible sheath 2 and the basket portion 4, and the calculus 230 is tightened to crush the 230. Will be.

In particular, the tip metal fitting 20 which is a feature of this embodiment is attached to the tip of the flexible sheath 2, and as shown in FIG. 2A, is made of a substantially cylindrical hard metal material and is fitted to the tip of the flexible sheath 2. The rear end of the flexible sheath 2 is composed of an annular portion 20a to be formed and a wire penetrating portion 20b composed of a plurality of protrusions 25 protruding toward the upper side of the annular portion 20a (direction toward the basket portion 4). A plurality of basket wires 8 extending from the chip 7 are configured to extend outward in the circumferential direction through a notch 26 which is a gap between the plurality of protrusions 25. That is, the tip metal fitting 20 according to the present embodiment has the annular portion 20a fitted to the tip of the flexible sheath 2 and the circumferential direction toward the upper side of the annular portion 20a (direction toward the basket portion 4). It is composed of a wire penetrating portion 20b composed of a plurality of protrusions 25 protruding at equal intervals. It can be manufactured by welding a plurality of protrusions at equal intervals.

The notch 26 formed between the plurality of protrusions 25 and the plurality of protrusions 25 is provided at least as many as the number of basket wires 8 in order to pass all the basket wires 8 constituting the basket portion 4. In the example, since there are four basket wires 8, four are provided. Further, the height of the protrusion 25 needs to be at least about the diameter of the basket wire 8 in order to spread the basket wire 8 and bring it into contact with the calculus, as will be described later, and the height is from twice the diameter of the basket wire 8. It is preferably about 3 times, and the width is preferably the same as the basket wire 8 or more.

In the tip fitting 20 configured in this way, when the stone 230 is pulled toward the tip fitting 29 by using the conventional annular tip fitting 29 as shown in FIG. 2B (a), the lower end of the stone 230 is obtained. When the basket wire 8 is pressed against the opening of the tip fitting 29 by the force F on the side, the plurality of basket wires 8 extending from the annular opening of the tip fitting 29 undergo plastic deformation (permanent strain) at the wire bent portion 8a. When the basket wire 8 is bent and cannot be crushed because the basket wire 8 cannot be pulled in during the crushing operation of the stone 230, or when the basket portion 4 is to be pulled into the flexible sheath 2 after the stone 230 is crushed. The tip metal fitting 20 according to the present embodiment may cause problems such as the basket wire 8 being cut, being deformed and unable to be pulled in, and being unable to be opened again even if it is pulled in. As shown in FIG. 2B (a), since the root portion of the basket wire 8 is released in the circumferential direction and the force F on the lower end side of the stone 230 is not applied to the basket wire 8, the basket wire 8 is prevented from being damaged or deformed. It has the effect that it can.

That is, in the case of the annular tip metal fitting 29 according to the prior art, the force F on the lower side of the stone 230 is strongly applied to the root portion of the basket wire 8 to deform by a relatively large angle θ1 and strongly to the opening of the tip metal fitting 29. Since the basket wire 8 is pressed and is made of stainless steel having a wire diameter of about 0.2 mm to 1.0 mm, plastic deformation (permanent strain) remains, which causes problems of cutting and deformation. The tip metal fitting 20 according to the example allows the root portion of the basket wire 8 to escape in the circumferential direction through the notch portion 26 to greatly widen the bending angle θ2 and prevents the force F from the stone 230 from being applied to the basket wire 8. Therefore, it is possible to prevent the basket wire 8 from being damaged or deformed.

In the treatment tool for an endoscope device according to the present embodiment configured as described above, when the basket portion 4 is extruded from the tip side of the flexible sheath 2, the four basket wires 8 rotate according to the extruding, so that the tip is When the calculus 230 is fitted into the four notches 26 of the metal fitting 20 and the calculus 230 is tightened to crush the calculus 230, the root portion of the basket wire 8 is released through the notch 26 in the circumferential direction to release the calculus 230. In order to prevent the force F from being applied from the basket wire 8, it is possible to prevent the basket wire 8 from being damaged or deformed.

The width of the notch 26 formed by the plurality of protrusions 25 is preferably about 2.5 to 3 times the wire diameter in order to allow rotation of the basket wire 8 within the width of the notch 26. If the height (depth) of the notch 26 allows the basket wire 8 to rotate and is too long, the strength decreases . For example , when the basket wire diameter Φ is 0.3 mm, the height (depth) of the notch portion 26 is preferably about 0.875 mm to 1.05 mm.

In the above-mentioned Example 1, an example of preventing the basket wire 8 from being damaged or deformed only by the tip metal fitting 20 has been described, but the present invention is not limited to this, and a force from a calculus is applied to the basket wire. An embodiment described below will be described as a means for preventing the above.

As shown in FIG. 3, the treatment tool for an endoscope device according to the second embodiment includes a tip fitting 20 similar to that of the first embodiment, and a stopper 90 fitted to an opening of the tip fitting 20. That is, in the treatment tool for the endoscope device according to the present embodiment, a guide groove (longitudinal groove) 92 is engraved in the axial direction at a position facing the cutout portion 26 of the tip metal fitting 20, and in the axial direction of the tip metal fitting 20. A stopper 90 for extending and fitting is provided.

The schematic structure of the stopper 90 is such that a conical portion is provided at the tip of the cylinder, and a guide groove 92 having a semicircular shape into which a part of the basket wire 8 is fitted at 90 degree intervals is engraved in the axial direction on the bottom surface. When viewed from the side, as shown in FIG. 3B, guide grooves 92 having a semicircular shape are provided on four sides of a perfect circle.

In the treatment tool for the endoscope device according to the second embodiment, the stopper 90 is fitted in the direction of the arrow A so that the guide groove 92 is positioned in the notch 26 of the upper end opening of the tip fitting 20. It is composed.

In the treatment tool for an endoscope device configured in this way, the basket wire 8 at the base of the basket portion 4 is fitted into the guide groove 92 in a state where the basket portion 4 is projected from the tip metal fitting 20 and the basket portion 4 is opened. The stopper 90 is fitted into the opening of the tip metal fitting 20 so that the stopper 90 is fitted, and then the operation wire 3 is pulled in to make the basket portion 4 in a narrowed state, and a part of the basket portion 4 in the narrowed state is from the tip. The flexible sheath 2 in the protruding state is used by inserting it into the channel of the endoscope device.

In the treatment tool for the endoscope device according to the present embodiment, the operation wire 3 is pulled into the flexible sheath 2, the calculus 230 is captured in the gap of the basket portion 4, and the basket portion 4 is placed in the flexible sheath 2. Further, when the stopper 90 is further pulled in, the sharp tip portion of the stopper 90 hits the bottom surface of the calculus 230 to prevent the calculus 230 from bending the basket wire 8 strongly, and it is possible to prevent the basket wire 8 from being damaged or deformed. In particular, in the treatment tool for the endoscope device according to the present embodiment, for example, depending on the shape of the calculus 230 (for example, vertically long, oval, with multiple protrusions, polygonal shape), the calculus 230 hits the basket wire 8 only with the tip metal fitting 20. In this case, the basket portion 4 can be reduced in diameter to crush the stone while the sharp tip portion of the stopper 90 supports the bottom portion of the stone 230, and the basket wire 8 can be prevented from being damaged or deformed. In particular, since the stopper 90 according to this embodiment has an acute-angled tip, it can be pierced and crushed more easily in the case of a hard stone.

In the above-mentioned Examples 1 and 2, an example in which the outer circumference of the tip fitting 20 has a linear cylindrical shape linear in the axial direction has been described, but the tip fitting of the treatment tool for an endoscope device according to the present invention has the straight cylindrical shape. For example, as shown in FIG. 4, the notch 26 above the annular portion 20a may be configured to have a shape in which the tip thereof is curved inward and narrowed. That is, the plurality of protrusions 25 may be formed so as to be curved toward the center of the cylinder.

In the treatment tool for the endoscope device according to the present embodiment, in addition to the above-mentioned effects, the basket wire 8 is more easily expanded in the outer peripheral direction because the notch portion 26 is bent inward, and the basket wire 8 is the notch portion. The possibility of deviation from 26 can be reduced.

Further, in the above-mentioned Example 2, an example of applying the stopper 90 in which the guide grooves 92 having a semicircular shape are linearly engraved in the axial direction on the four side surfaces will be described, but for the endoscope device according to the present invention. The treatment tool is not limited to the shape of the embodiment, and as shown in FIG. 5A (a), the treatment tool is engraved so that the width on the bottom surface side is wider and wider toward the center than the upper side of the guide groove 92. The stopper 90 may be configured to fit into the opening of the tip metal fitting. That is, in the treatment tool for the endoscope device according to the present embodiment, the width of the guide groove (vertical groove) 92 of the stopper 90 on the flexible sheath (lower side) side may be wider than that on the tip side. ..

In addition to the above-mentioned effects, the treatment tool for the endoscope device according to the fourth embodiment has an improved degree of freedom in the position inside the flexible sheath 2 of the basket wire 8 passing from the flexible sheath 2 to the tip fitting, and the stopper 90. The operability when fitting the basket wire 20 to the tip metal fitting 20 is improved, and the basket wire 8 can be further taken in and out.

In Examples 2 and 4 described above, an example in which the outer diameter of the stopper 90 is entirely within the inner diameter of the tip metal fitting 20 has been described, but the present invention is not limited to these examples and is shown in FIG. 5B (a). As described above, an annular locking portion 99 having a flange shape protruding in the outer peripheral direction is provided in the middle of the annular portion 20a, and when viewed from the bottom surface side, the guide groove 92 provides the annular locking portion 99 as shown in FIG. 5 (b). A fitting portion 90a that is engraved in a semicircular shape on all four sides and fits into the inner diameter of the tip fitting 20, and a wire protruding portion that protrudes upward (toward the tip) from the tip fitting 20 and the fitting portion 90a. 90b may be provided. That is, the treatment tool for the endoscope device according to the present embodiment has a dimension in which the stopper 90 protrudes from the tip metal fitting 20 by providing the annular locking portion 99 that fits into the tip metal fitting 20 in the middle of the axial direction of the stopper 90. Can be set, and the stopper protrusion dimension in which the stopper 90 does not hit the basket wire 8 but hits the stone 230 can be set according to the shape of the stone 230 (for example, vertically long, elliptical, with multiple protrusions, polygonal shape). .. That is, regardless of the shape of the calculus 230, the calculus 230 can be prevented from bending the basket wire 8 strongly, and the basket wire 8 can be prevented from being damaged or deformed.

In addition to the above-mentioned effects, the treatment tool for the endoscope device according to this embodiment has a dimension from the tip of the flexible sheath 2 to the tip of the stopper 90 by adjusting the position where the ring locking portion 99 is provided. Can be set. In other words, since the dimension from the tip of the tip metal fitting 20 to reach the calculus 230 can be set depending on the position where the ring locking portion 99 is provided, the shape of the calculus 230 (approximately perfect circle, substantially elliptical shape, polygonal shape) can be set. Calculus can be easily crushed and trapped in the basket portion 4 depending on the shape (square shape, presence / absence of large protrusions, etc.).

Further, the stopper 90 of the treatment tool for the endoscope device according to the present invention is not limited to the above-described embodiment shape, and as shown in FIG. 5A (b), the lower end (sheath side) of the guide groove 92 of the stopper 90. A guide hole 95 may be provided in which the above is deleted. In addition to the above-mentioned effects, the stopper 90 according to the fifth embodiment can further facilitate the insertion and removal of the basket wire 8 from the flexible sheath 2 through the tip metal fitting 20. Further, the stopper 90 according to the present invention may be a combination of Examples 4 and 5.

2 Flexible sheath, 3 Operation wire, 4 Basket part, 6 Tip tip, 7 Tip, Rear tip,
8 basket wire, 8a wire bent part, 10 operation part, 11 operation part main body,
12 Operation pipe, 13 Water supply port, 14 Grip part, 20 Tip fitting, 20a Annulus part,
29 Tip fitting, 50 Tip curved part, 90 Stopper, 90a fitting part,
90b wire protrusion, 92 guide groove, 99 annulus locking part, 210 papilla, 230 stone

Claims (6)

With a long cylindrical flexible sheath,
An operation wire that is freely inserted and retracted into the cylinder of the flexible sheath,
A basket portion provided at the tip of the operation wire and formed so that a plurality of basket wires having a predetermined diameter are elastically reduced in diameter or expanded.
A tip fitting attached to the tip of the flexible sheath and through which an operation wire provided with the basket portion is inserted.
In a basket-type endoscope device treatment tool for capturing stones and the like by reducing the diameter of the basket wire .
The tip metal fitting
A plurality of protrusions made of a substantially cylindrical hard material, having an annular portion fitted to the tip of the flexible sheath and projecting at equal intervals with a width in which the basket wire is fitted in the direction of the basket portion of the annular portion. It is composed of parts, and when the height of the plurality of protrusions is set to about 2 to 3 times the predetermined diameter of the basket wire and the diameter of the basket wire is reduced to capture stones or the like. For a basket-type endoscope device , the lower surface of the sword and the like is configured to be in contact with the upper end of the protrusion, and the upper ends of the plurality of protrusions are formed so as to face the cylindrical center of the tip fitting. Treatment tool. The treatment tool for a basket-type endoscope device according to claim 1, wherein the plurality of protrusions are provided at least as many as the number of the basket wires. A vertically long guide groove is engraved in the axial direction at a position facing the notch formed between the protrusions of the tip metal fitting, and a stopper that extends in the axial direction of the tip metal fitting and is fitted is provided. The treatment tool for a basket-type endoscope device according to claim 1 or 2, wherein the treatment tool is characterized. The treatment tool for a basket-type endoscope device according to claim 3 , wherein the vertically long guide groove of the stopper is engraved with a wider width on the flexible sheath side than on the tip side. The third or four claim, wherein the stopper is provided with an annular locking portion in the circumferential direction, which is fitted in the axial direction of the tip fitting and defines a dimension protruding from the tip fitting. Treatment tool for basket-type endoscope equipment. The procedure for a basket-type endoscope device according to any one of claims 3 to 5, wherein the stopper is provided with a guide hole from which the end of the vertically long guide groove on the flexible sheath side is removed. Ingredients.

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