JP7153989B2 - Treatment instrument for basket-type endoscope - Google Patents

Description

The present invention relates to a basket-type endoscopic treatment instrument.

In general, a basket-type endoscopic treatment instrument comprises a plurality of basket wires whose both ends are combined into a rear end tip and a front end tip and connected to the distal end of an operation wire inserted through a flexible sheath. A plurality of basket wires protruding from the flexible sheath are bent outward by advancing operation of the operation wire to widen the wire interval, and the plurality of basket wires in this state are closed together by retraction operation of the operation wire. function to be housed within the distal end of the flexible sheath.

When a basket-type endoscopic treatment instrument is used by being inserted into a bile duct or the like, it is inserted into an endoscope channel, and the endoscope is inserted into a body cavity such as the bile duct under fluoroscopy. When the tip side opening faces the body cavity in which a foreign object such as a calculus to be removed exists, the guide wire in the endoscope is operated to advance into the body cavity in which the foreign object exists through the tip side opening. After that, the flexible sheath is engaged and guided by the guide wire to enter the body cavity where the foreign object is present, and after the guide wire is retracted at the position where the foreign object is present, the operation wire is advanced to The basket portion extending forward from the flexible sheath spreads a plurality of basket wires, catches foreign matter by retracting the operation wire, and narrows the pressure between the distal end fitting provided at the distal end of the sheath and the distal tip as necessary. The foreign matter is crushed by

JP 2014-30492 A JP 2011-19937 A Japanese Unexamined Patent Application Publication No. 2018-33489

In the above-mentioned basket-type endoscopic treatment instruments of Patent Documents 1 to 3, the distal tip is engaged and guided by a rigid guide wire, and the flexible sheath is constrained so as to move coaxially with the guide wire. Since the flexible sheath is designed to be inserted into a body cavity such as a body cavity, there is a problem that insertion resistance of the flexible sheath is large and insertion into the body cavity is difficult.

SUMMARY OF THE INVENTION The present invention has been made to solve such problems. An object of the present invention is to provide a basket-type endoscopic treatment instrument which is inserted into a body cavity such as a bile duct, has a small insertion resistance of a flexible sheath, and is easily inserted into the body cavity.

In order to achieve the above object, a basket-type endoscopic treatment instrument according to the present invention provides a rear end tip of a front end portion of an operation wire inserted through a flexible sheath and a front end tip ahead of the rear end tip. has a plurality of basket wires fixed thereto, and when these basket wires are pushed forward from inside the distal end portion of the flexible sheath by the operation wire, the middle elastically returns to the bent state to the outside and the A basket portion for enlarging the wire spacing of the basket wire to take in foreign matter inside, and a basket portion provided in the distal tip for guiding along the guide wire while maintaining a state in which the basket portion is inside the distal end portion of the flexible sheath. guidewire engaging means.

The guide wire engaging means includes a first groove recessed in the distal tip so as to have a required depth from the distal end face, and a groove shallower than the first groove on both sides of the first groove. having a second groove and a third groove recessed to have a required depth, wherein the second groove and the third groove are provided on a straight line that intersects the first groove; a guide wire engaging ring partly accommodated in the first groove and through which the guide wire is inserted; It is characterized by having a guide wire locking bar accommodated and fixed in the second groove and the third groove.

According to the present invention, the distal end portion of the flexible sheath is engaged and guided by the guide wire with a predetermined crossing angle that provides low frictional resistance to the guide wire, and is inserted into a body cavity such as a bile duct. It is possible to provide a basket-type endoscopic treatment instrument in which insertion resistance of a flexible sheath is small and insertion into a body cavity is easy.

1 is a schematic principle diagram of a basket-type endoscopic treatment instrument according to Embodiment 1 of the present invention; FIG. Fig. 2(a) is a longitudinal front view and Fig. 2(b) is a side view of a distal tip provided with a guide wire engaging means, which is a main part of a basket-type endoscopic treatment instrument according to Embodiment 1 of the present invention. FIG. 2(c) is a plan view. FIG. 3 is a manufacturing process diagram of the distal tip before the guide wire engaging means shown in FIG. 2 is provided; FIG. 4 is a process chart for explaining a treatment by a doctor using the basket-type endoscopic treatment instrument of Embodiment 1; FIGS. 4(a) and 4(b) are diagrams showing first to third grooves provided on the distal end surface of the distal tip according to the modification corresponding to FIG. 2(d). 6(a), (b), and (c) are manufacturing process diagrams of the guide wire engaging means according to the modification corresponding to FIGS. 2(a), (b), and (c). 7(a) is a longitudinal front view, FIG. 7(b) is a side view, and FIG. 7(c) is a plan view showing a distal tip provided with a guide wire engaging means according to Embodiment 2 of the present invention. be. Fig. 8(a) is a front view and Fig. 8(b) is a plan view showing a distal tip provided with guide wire engaging means according to Embodiment 3 of the present invention. FIG. 11 is a vertical cross-sectional front view showing a distal tip provided with a guide wire engaging means according to a modification of Embodiment 3 of the present invention; Fig. 10(a) is a front view and Fig. 10(b) is a plan view showing a distal tip provided with a guide wire engaging means according to Embodiment 4 of the present invention. FIG. 11 is a vertical cross-sectional front view showing a distal tip provided with a guide wire engaging means according to a modification of Embodiment 4 of the present invention;

BEST MODE FOR CARRYING OUT THE INVENTION An embodiment of a basket-type endoscopic treatment instrument according to the present invention will be described below with reference to the drawings. In this embodiment, the side on which the basket portion is located is called the front end side, and the side on which the operating portion is located is called the rear end side.

[Embodiment 1]
[Basic configuration]
As shown in FIG. 1, a basket-type endoscopic treatment instrument 1 according to Embodiment 1 includes an elongated flexible sheath 2 and a cylindrical tip fitting attached and fixed to the distal end side of the flexible sheath 2. 3, an operation wire 4 that is inserted into the flexible sheath 2 so as to move back and forth, an operation portion 5 that is connected to hold the rear end of the operation wire 4 and moves the operation wire 4 back and forth, and the operation wire 4. a rear end tip 11 fitted and fixed to the front end of the basket, a front end tip 15 provided at the front position of the rear end tip 11, and a plurality of basket wires 12 elastically stored in a curved shape in the middle. 13.

The flexible sheath 2 has, for example, a cylindrical shape with a length of 500 to 2000 mm and an outer diameter of 1.8 mm. , fluorocarbon resin such as polytetrafluoroethylene (PTFE) or polyether block amide.

The tip fitting 3 is, for example, a short cylindrical body made of metal, and is fitted over the flexible sheath 2 and fixed with an adhesive or other joining means.

For example, the operation wire 4 may be made entirely of stainless steel, or may be made of stainless steel on the rear end side and Nitinol (nickel-titanium alloy) on the front end side, both of which are connected by a stainless steel pipe.

The operation portion 5 includes an operation portion main body 6 which is a molded body made of polycarbonate, for example, and a grip portion 9 having an operation pipe 10 . The operating portion main body 6 has a drug solution delivery path 7 to which the flexible sheath 2 is connected, and has an injection port 8 to which a syringe or the like is connected at the rear end of the drug solution delivery path 7 . The grasping portion 9 extends through the rear end portion of the operation portion main body 6 through the operation pipe 10 into the drug solution delivery path 7, accommodates the rear end portion of the operation wire 4, and is fixed thereto. Therefore, the operating wire 4 can be moved in the longitudinal direction within the flexible sheath 2 by operating the gripping portion 9 to advance and retreat. Also, a syringe or the like (not shown) can be attached to the injection port 8 to feed the liquid medicine into the flexible sheath 2 .

The rear tip 11 and the front tip 15 are short cylindrical bodies made of stainless steel, for example. The rear end tip 11 accommodates and fixes the distal ends of the operation wires 4 in the rear half of the cylinder, and accommodates the bundled rear ends of the plurality of basket wires 12 in the rear half of the cylinder. and fixed. The distal tip 15 accommodates and fixes distal ends of a plurality of basket wires 12 in a bundled state in a hole opened on the rear surface.

The basket portion 13 is composed of a plurality of basket wires 12 made of Nitinol (nickel-titanium alloy), which is a superelastic alloy and a shape memory alloy, for example. The number of the basket wires 12 is in the range of three to more than ten. Each basket wire 12 is a metal wire having elastic restoring force, and both ends are arranged on the same axis, and the ends other than the ends are connected to each other. For example, the same curved shape, such as a semi-elliptical shape, is stored from one axis. The basket portion 13 is housed in the endoscope in a state in which both ends of the bundled basket wires 12 are fixed to the rear tip 11 and the distal tip and housed in the distal end portion of the flexible sheath 2 . When the grasping portion 9 is moved forward and backward during treatment, the midpoints of each of the plurality of basket wires 12 expand inwardly in the circumferential direction with respect to the center line connecting the rear tip 11 and the front tip. to form a space for taking in foreign matter.

[Characteristic configuration]
As shown in FIGS. 2(a) to 2(c), the characteristic configuration of Embodiment 1 is a guide wire engaging means 25 provided at the distal end of a distal tip 15 connected to a plurality of basket wires 12. be. The guide wire engaging means 25 has a guide wire engaging ring 26 attached to the distal end of a cylindrical distal tip 15 smaller than the inner diameter of the flexible sheath 2 , and the basket portion 13 is attached to the flexible sheath 2 . The guide wire 14 is inserted through the guide wire engaging ring 26 that is housed in the distal end of the flexible sheath 2 and protrudes from the flexible sheath 2 , and when the flexible sheath 2 is advanced, the guide wire is engaged along the guide wire 14 . The flexible sheath 2 is guided along the guide wire 14 by engaging and guiding the coupling means 25 .

3(a)-(d) show a fabrication process diagram of the distal portion of distal tip 15, which may include guidewire engaging means 25. FIG.

First, as shown in FIG. 3A and FIG. 3B which is a bottom view of FIG. A plurality of basket wires 12 are bundled and housed in the hole of the tip tip 15, and the gap in the hole is filled. The end tip 15 and the end portions of the plurality of basket wires 12 are integrally joined by filling silver solder, solder, or adhesive in the .

Next, as shown in FIG. 3(c) and FIG. 3(d), which is a plan view of FIG. 3(c), a first groove 21 and a , a second groove 22 and a third groove 23 are provided. The first groove portion 21 is recessed with a required depth at a position passing through the diameter of the distal end surface of the distal tip 15 . The second groove portion 22 and the third groove portion 23 are recessed on both sides of the first groove portion 21 so as to have a required depth shallower than the first groove portion 21. The groove portion 23 is provided at a position on a straight line passing through the diameter of the distal end surface of the distal tip 15 that intersects the first groove portion 21 at right angles.

Then, as shown in FIGS. 2(a) to 2(c), a part of the guide wire engaging ring 26 is accommodated in the first groove portion 21 of the distal tip 15, and the guide wire engaging bar 27 is engaged with the guide wire. The center of the guide wire locking bar 27 is pressed against the guide wire locking bar 27 so that both ends of the guide wire locking bar 27 are inserted into the second groove 22 of the distal tip 15 . and are housed in and fixed to the third groove portion 23 . The fixing of the guide wire locking bar 27 to the second groove 22 and the third groove 23 of the distal tip 15 is performed by silver brazing, soldering, adhesive, laser welding, or the like.

As described above, in the guide wire engaging means 25 of the first embodiment, the distal tip 15 is formed in a cylindrical shape having an outer diameter smaller than the inner diameter of the flexible sheath 2, and the distal tip 15 has a cylindrical hole. The ends of a plurality of basket wires 12 are accommodated and fixed by laser welding or by a fixing material filled in the gaps in the cylindrical holes. A first groove portion 21 recessed to have a deeper required depth, a second groove portion 22 recessed to have a shallower required depth than the first groove portion 21 on both sides of the first groove portion 21, and A third groove portion 23 is provided, the second groove portion 22 and the third groove portion 23 are provided on a straight line that intersects the first groove portion 21, and the second groove portion 22 and the third groove portion 22 in the first groove portion 21 are aligned. a guide wire engaging ring 26 for inserting the guide wire 14 through the remaining portion protruding from the distal end surface of the distal tip 15; The structure has a guide wire locking bar 27 which is passed through the guide wire engaging ring 26 and is accommodated and fixed in the second groove 22 and the third groove 23 in a state of pressing the guide wire engaging ring 26. be.

The outer surface of the portion to be inserted into the body cavity from the flexible sheath 2 to the guide wire engaging means 25 shown in FIG. 1 is hydrophilically coated.

The guidewire engaging ring 26 is a biocompatible metal ring or resin ring that has a tensile strength unless it is easily broken by the force acting when the flexible sheath 2 is guided along the guidewire 14 . I wish I had. If the metal ring and the resin ring are too large, they will not enter the bile duct, so an appropriate size is required. Moreover, if the metal ring and the resin ring are too hard, they may damage the bile duct wall and the papilla, so they should have appropriate softness. The guide wire engaging ring 26 may be, for example, a ring of a PTFE micro-diameter tube, or a ring of fishing line. For example, if it has a tensile strength of 3 kg, it can be applied as a product.

Assuming that the guide wire engaging ring 26 is passed through the guide wire 14 at an intersection angle of 45 degrees and is guided by the guide wire 14, for example, if the guide wire 14 has a thickness of 0.89 mm and the guide wire When the thickness of the wire locking bar 27 is 0.15 mm, the minor axis of the elliptical shape seen obliquely from the metal ring must be larger than 1.05 mm. In the case of , the ring shape is deformed, so the dimension must be greater than 0.2 mm.

FIGS. 4(a) to 4(c) are process diagrams for explaining treatment by an operator using the basket-type endoscopic treatment instrument 1 of Embodiment 1. FIG.

First, as shown in FIG. 4(a), the endoscope 40, in which the guide wire 14 and the basket-type endoscopic treatment instrument 1 are housed in the endoscope channel, is placed under fluoroscopy with an angiographic agent and radiography. and insert it into the duodenum with the tip side opening of the endoscope 40 facing the vicinity of the papilla 42 where there is a foreign object 44 such as a calculus to be removed, and then the guide wire in the endoscope 40 14 is made to protrude from the opening on the side of the distal end and enter the bile duct 43, and then enter to a desired position beyond the position where the foreign body 44 exists.

Next, as shown in FIG. 4(a), the flexible sheath 2 is engaged and guided by the guide wire 14 and is advanced into the bile duct 43 and advanced to a desired position beyond the position where the foreign body 44 exists. . Subsequently, as shown in FIG. 4(b), the guide wire 14 is retracted into the endoscope 40, and then the operation wire 4 is advanced to move the basket portion 13 accommodated in the distal end portion of the flexible sheath 2. advances ahead of the flexible sheath 2 to make the plurality of basket wires 12 spread out.

Next, as shown in FIG. 4(c), the foreign matter 44 is captured and collected in the basket portion 13 by retracting the operating wire, or if the foreign matter 44 is large, the basket portion 13 can be moved by retracting the operating wire. The foreign matter 44 in the basket part 13 is crushed by changing the force to pull it into the flexible sheath 2 into the narrow pressure between the distal fitting 3 and the distal tip 15. - 特許庁

When the flexible sheath 2 advances from the papilla 42 into the bile duct 43 with the guide wire engaging ring 26 at the front by the above-described advance operation of the operating wire, the guide wire engaging ring 26 is attached to the guide wire 14. Since the flexible sheath 2 follows the guide wire engagement ring 26, which has a crossing angle of a required angle and is guided by the guide wire 14, smoothly without causing a large entry resistance. A flexible sheath 2 can enter the bile duct 43 . Moreover, since the guide wire engaging ring 26 is annular, there is no risk of damaging the papilla 42 or the wall of the bile duct 43 .

Further, in the event that the guide wire engagement ring 26 is broken due to sliding friction with the guide wire 14 due to the forward/backward movement of the operating wire, the guide wire locking bar 27 presses the guide wire engagement ring 26. Therefore, the guide wire engaging ring 26 will not be detached, and the guide wire engaging ring 26 will not be left in the bile duct 43 in a detached state.

[Modification of Embodiment 1]
3(a)→FIG. 3(c)→FIG. 2(a) is an example of the manufacturing process of the guide wire engaging means 25, and is not limited to this. For example, after providing the first groove 21, the second groove 22 and the third groove 23 in the distal end of the distal tip 15 shown in FIG. A fixed configuration may be used.

As shown in FIG. 5A, a straight line connecting the second groove portion 22 and the third groove portion 23 is provided so as to intersect the first groove portion 21 at a right angle at a position avoiding the diameter thereof. Alternatively, as shown in FIG. 5B, the straight line connecting the second groove portion 22 and the third groove portion 23 is at a position away from the diameter of the first groove portion 21 and at a right angle. The configuration may be such that they intersect at an angle that is not

As shown in FIG. 6(a), a plurality of basket wires 12 are inserted and fixed into the hole of a cylindrical distal tip 15 whose distal end surface is inclined at, for example, 30 to 45°. As shown in (b), the first groove portion 21 is provided in a direction perpendicular to the direction of inclination of the inclined surface and inclined with respect to the center line of the distal tip 15, and the second groove portion 22 and the third groove portion 22 are provided. A groove portion 23 is provided in the inclined direction of the distal end surface of the distal tip 15, and then, as shown in FIG. Both ends of the bar 27 may be housed in the second groove 22 and the third groove 23 and fixed with silver brazing or the like so that the bar 27 is passed through the guide wire engagement ring 26 and pressed.

[Embodiment 2]
[Basic configuration]
The basic configuration (overall configuration) of the basket-type endoscopic treatment instrument is the same as the basic configuration of Embodiment 1 except for the distal tip 15A, so a diagram corresponding to FIG. 1 and description thereof are omitted.

[Characteristic configuration]
FIGS. 7(a) to (c) show a distal tip 15A having a guide wire engaging means 25A. FIG. 7(a) is a longitudinal front view, FIG. 7(b) is a side view, and FIG. c) is a plan view. A characteristic configuration resides in a configuration in which a guide wire engaging means 25A is provided at the distal end of a distal tip 15A connected to a plurality of basket wires 12. As shown in FIG. The guide wire engaging means 25A has a guide wire engaging ring 26 attached to the distal end of a cylindrical distal tip 15A having an outer diameter smaller than the inner diameter (the same diameter as in the first embodiment) in a flexible sheath. A wire engaging ring 26 is pressed by a guide wire locking bar 27 .

Regarding Embodiment 2 As the same configuration as Embodiment 1, the distal tip 15A has a cylindrical outer surface and the outer diameter of the cylindrical outer surface is smaller than the inner diameter of the flexible sheath 2, and the distal end of the distal tip 15A a first groove portion 21A, a second groove portion 22 and a third groove portion 23; a guide wire engaging ring 26 is accommodated in the first groove portion 21A; and a guide wire locking bar 27 is engaged with the guide wire. Both end portions are accommodated and fixed in the second groove portion 22 and the third groove portion 23 so as to pass through the coupling ring 26 and press the guide wire engaging ring 26 at the central portion of the guide wire locking bar 27 . , is.

The configuration of the second embodiment that differs from the first embodiment resides in the connection structure between the distal tip 15A and the basket wire 12A. The distal tip 15A has a lower small-diameter hole 28 and an upper large-diameter hole 29 that divides the first groove 21, which are connected on one axis and penetrate through the center. It is provided deeper than the first groove portion 21 .

Each of the plurality of basket wires 12 has a plurality of loop portions 30 in which the ends connected to the distal tip 15A are folded back one by one and bundled. 28 and the upper large-diameter hole 29, and the locking pin 31 is inserted through the plurality of loops 30 above the tip 15A, and the loops 30 and the locking bar 31 are pushed down and By pulling the basket wire 12 downward below the distal tip 15A, the loop portion 30 is brought into contact with the steps of the lower small diameter hole portion 28 and the upper large diameter hole portion 29, and the latch pin 31 is pulled downward. are hooked to the bottom of the first groove 21, thereby connecting the distal tip 15A and the plurality of basket wires 12. As shown in FIG.

The guide wire engaging ring 26 is accommodated in the first groove portion 21 and rests on the loop portion 30 of the basket wire 12, and the guide wire locking bar 27 presses the guide wire engaging ring 26 to the second position. It is fixed to the groove portion 22 and the third groove portion 23 .

The effects of the guide wire engaging means 25A are the same as those of the first embodiment.

[Embodiment 3]
[Basic configuration]
The basic configuration (overall configuration) of the basket-type endoscopic treatment instrument is the same as the basic configuration of the first embodiment except for the distal tip 15B, so a diagram corresponding to FIG. 1 and description thereof will be omitted.

[Characteristic configuration]
8(a) and 8(b) show a distal tip 15B having a guide wire engaging means 25B, FIG. 8(a) being a longitudinal front view and FIG. 8(b) being a plan view. A characteristic configuration resides in a configuration in which a guide wire engaging means 25B is provided at the distal end of a distal tip 15B connected to a plurality of basket wires 12 . In the guide wire engaging means 25B, a guide wire engaging ring 26 is attached to the distal end portion of the distal tip 15B having a two-stage axial outer peripheral surface, and the guide wire engaging ring 26 is pressed by a guide wire locking bar 27. It is

The guide wire engaging means 25B may have a rear small-diameter cylindrical portion 15B1 having an outer diameter smaller than the inner diameter of the flexible sheath 2 and an outer diameter larger than the inner diameter of the flexible sheath 2 at the distal tip 15B. It has a shape having an outer peripheral surface composed of a front large-diameter cylindrical portion 15B2 that abuts on the distal end surface of the flexible sheath 2. The tips of a plurality of basket wires 12 are accommodated and fixed by laser welding or by a fixing material filled in the gaps in the cylindrical holes. It should be noted that the rear small-diameter tubular portion 15B1 may be provided long, and the tips of the plurality of basket wires 12 may be accommodated and fixed in the rear small-diameter tubular portion 15B1. In addition, as shown in FIG. 9, the cylindrical body 19 may be fitted and fixed to the rear small-diameter cylindrical portion 15B1.

The effects of the guide wire engaging means 25A are the same as those of the first embodiment.

[Embodiment 4]
[Basic configuration]
FIG. 10 is a schematic configuration diagram of a partial configuration of a basket-type endoscopic treatment instrument 1C according to Embodiment 4 of the present invention. The basic configuration of the basket-type endoscopic treatment instrument 1C is the same as that of the first embodiment except for the distal tip 15C, so the description is omitted.

[Characteristic composition]
A characteristic configuration of the fourth embodiment is a guide wire engaging means 25C provided at the distal end of the distal tip 15C. Regarding the guide wire engaging means 25C provided at the distal end portion of the distal tip 15C, the shape of the outer peripheral surface of the distal tip 15C of Embodiment 3 shown in FIG. , which is the same as the shape of the outer peripheral surface of the distal tip 15B shown in FIG. Also, the connection structure between the distal tip 15C and the basket wire 12 is the same as that of the second embodiment shown in FIG. As for the structure in which the first groove portion 21, the second groove portion 22 and the third groove portion 23 are provided at the distal end portion of the distal tip 15C, and the guide wire engaging ring 26 and the guide wire locking bar 27 are provided, It is the same as the third embodiment shown in FIG. Therefore, the reference numerals attached in FIG. 10 are the same as the reference numerals of the elements corresponding to those in FIGS. In addition, as shown in FIG. 11, the cylindrical body 19 may be fitted and fixed to the rear small-diameter cylindrical portion 15C1.

The effects of the guide wire engaging means 25C are the same as those of the first embodiment.

According to the present invention, the distal end portion of the flexible sheath is engaged and guided by the guide wire with a predetermined crossing angle that provides low frictional resistance to the guide wire, and is inserted into a body cavity such as a bile duct. The flexible sheath has a small resistance to insertion and can be easily inserted into a body cavity, and is useful as a basket-type endoscopic instrument for trapping and removing gallstones in the bile duct.

REFERENCE SIGNS LIST 1 basket-type endoscopic instrument 2 flexible sheath 4 operation wire 5 operation part 6 operation part main body 7 chemical solution delivery path 8 injection port 9 grip part 10 operation pipe 11 rear end tip 12 basket wire 13 basket part 14 Guide wire 15 Distal tip 16 Tip main body 17 Rear small diameter cylinder 18 Front large diameter cylinder 19 Cylindrical body 21 First groove 22 Second groove 23 Third groove 25 Guide wire engaging means 26 For guide wire engagement Ring 27 Guide wire locking bar

Claims (6)

A plurality of basket wires having both ends fixed to a rear end tip of a front end portion of an operation wire inserted through a flexible sheath and a front end tip ahead of the rear end tip, and these basket wires are connected to the operation wire by the operation wire. a basket portion that, when pushed forward from inside the distal end portion of the flexible sheath, elastically returns to a curved state in the middle thereof to widen the wire spacing of the basket wires and take in foreign substances;
guide wire engaging means provided on the distal tip for guiding the flexible sheath along the guide wire while maintaining the basket portion inside the distal end portion of the flexible sheath;
The guidewire engaging means comprises:
The distal tip has a first groove recessed to have a required depth from the tip face, and recesses are recessed to have a required depth shallower than the first groove on both sides of the first groove. having a second groove and a third groove, wherein the second groove and the third groove are provided on a straight line that intersects the first groove;
a guide wire engaging ring partially accommodated in the first groove and for inserting the guide wire;
It has a guide wire locking bar that is passed through the guide wire engaging ring and is housed and fixed in the second groove and the third groove while pressing the guide wire engaging ring. A basket-type endoscopic treatment instrument. The guide wire engaging means has a tubular tip body having an outer diameter smaller than the inner diameter of the flexible sheath at the distal tip, and a plurality of basket wires are arranged in the tubular hole of the tip body. 2. The treatment instrument for a basket-type endoscope according to claim 1, wherein the distal end of the basket-type endoscopic treatment instrument is accommodated and is fixed by laser welding or by a fixing material filled in a gap in the cylindrical hole. The guide wire engaging means has a cylindrical tip body having an outer diameter smaller than the inner diameter of the flexible sheath at the distal tip, and the distal ends of the plurality of basket wires are looped. 2. The basket-type endoscopic treatment according to claim 1, wherein the portion is accommodated in the cylindrical hole of the tip body and is inserted through the loop portion, and has a locking pin that is fixed at both ends to the tip body and hooks the loop portion. equipment. The guide wire engaging means has, at the distal tip, a rear small-diameter tubular portion having an outer diameter smaller than the inner diameter of the flexible sheath and an outer diameter larger than the inner diameter of the flexible sheath. It has a tip body including a front large-diameter tubular portion that abuts on the distal end surface of the flexible sheath, and a plurality of tips are provided in at least the rear small-diameter tubular portion among the rear small-diameter tubular portion and the front large-diameter tubular portion. 2. The therapeutic instrument for a basket-type endoscope according to claim 1, wherein the distal end of said basket wire is accommodated and fixed by laser welding or by a fixing material filled in a gap in the cylindrical hole. The guide wire engaging means has, at the distal tip, a rear small-diameter tubular portion having an outer diameter smaller than the inner diameter of the flexible sheath and an outer diameter larger than the inner diameter of the flexible sheath. It has a tip body including a tip large-diameter cylindrical portion that abuts on the tip surface of the flexible sheath, and the tips of the plurality of basket wires are loop-shaped, and the loop portion is connected to the rear small-diameter cylindrical portion and the tip large-diameter tube. 2. The inside of the basket mold according to claim 1, further comprising a locking pin which is housed in at least the rear small diameter cylindrical portion of the diameter cylindrical portion, is inserted through the loop portion, has both ends fixed to the chip body, and locks the loop portion. Endoscopy instrument. 5. The guide wire engaging means has, at the distal tip, a tubular body having an outer diameter smaller than the inner diameter of the flexible sheath and a distal end portion of which is fitted and fixed to the rear small-diameter tubular portion. 6. The basket-type endoscopic treatment instrument according to 5.

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