JP7286067B2 - Endoscope Microwave Irradiator - Google Patents

Description

The present invention relates to an endoscopic microwave irradiation instrument.

2. Description of the Related Art Conventionally, a high-frequency surgical instrument for an endoscope has been used for performing treatments such as cutting living tissue and stopping bleeding with high-frequency current using an endoscope. As such an endoscope high-frequency treatment instrument, there is a scissors provided at the distal end thereof, which is capable of excising a diseased part in a body cavity or an internal cavity, or performing treatment such as cutting or incision of living tissue. be.

Specifically, an endoscopic high-frequency treatment instrument having scissors includes, for example, a sheath that is passed through a treatment instrument guide tube of the endoscope, and a proximal end side (closer to the operator) of the sheath. and a treatment section provided on the distal end side of the sheath (the side farther from the operator). An operator can operate the operation section to open and close a pair of blade sections that constitute the scissors provided in the treatment section. The blade portion is used as a high-frequency electrode, and by applying a high-frequency current while a living tissue such as a blood vessel is gripped, the tissue in the vicinity of the gripped portion is cauterized and coagulated, and bleeding can be stopped (for example, , see Patent Document 1).

Patent Document 1 discloses a conductive operation wire inserted reciprocally through a sheath, a treatment section disposed at the distal end of the operation wire, and a treatment section provided at the proximal end of the sheath for advancing and retracting the operation wire. An endoscope high-frequency treatment instrument is disclosed that includes an operating section that is operated to operate the treatment section. The treatment portion is provided with scissors used as electrodes, and a high-frequency voltage is applied to the scissors. The scissors are held by the holding frame so that the pair of blades can rotate.

JP 2016-87450 A

In general, a high-frequency surgical instrument for an endoscope is used to cauterize or cut living tissue by applying a high-frequency current to the living tissue to generate Joule heat. may not be suitable. An endoscopic treatment instrument that can appropriately cauterize living tissue and stop bleeding using non-mechanical energy such as electromagnetic waves, and that can reliably cut living tissue using mechanical scissors. Expected to be developed.

Further, scissors generally provided in high-frequency treatment instruments for endoscopes can stably shear living tissue or the like because the relative operating positions of the pair of blade portions are always constant. However, in the endoscopic high-frequency treatment instrument described in Patent Document 1, a pair of blades (scissors) is provided between a pair of arms of a resin holding frame that is weaker in strength than metal scissors. This is a rotatably supported structure, and there is a problem that the holding frame is bent or out of position due to the force received from the scissors during cutting. If the holding frame is flexed or misaligned, there is a concern that the relative operating positions of the pair of blades may become unstable, resulting in poor sharpness of the scissors.

SUMMARY OF THE INVENTION The present invention has been made to solve the above-mentioned problems. An object of the present invention is to provide a microwave irradiation instrument for an endoscope that can be maintained.

In order to achieve the above object, an endoscopic microwave irradiation instrument according to the present invention includes an energy transmission cable, a microwave irradiation section connected to the cable, and a sheath for housing the cable. A microwave irradiation instrument for a microscope, wherein the cable is composed of a coaxial cable having a central conductor, a tubular insulator surrounding the central conductor, and an outer conductor surrounding the tubular insulator, The microwave irradiation unit has a fixed blade connected to the outer conductor, and a movable blade connected to the central conductor and opening and closing with respect to the fixed blade, and between the movable blade and the fixed blade comprises an insulating support member made of an insulating material and movably supporting the movable blade in a predetermined direction; The holding member on both sides is interposed.

With this configuration, the movable blade is movably held in a predetermined direction from both sides by the two-side holding members integrated with the fixed blade through the insulating support member, so that the relative operating positions of the movable blade and the fixed blade can be stabilized. The good sharpness of scissors consisting of a movable blade and a fixed blade can be maintained.

Further, in the endoscopic microwave irradiation device according to the present invention, the two-side holding member includes a pair of parallel arm portions for coaxially holding the insulating support member with respect to the coaxial cable, and bases of both parallel arm portions. The configuration may also include an annular portion for integrally fixing the end portion to the fixed blade.

With this configuration, the shape can be set so that the insulating support member can be stably held, and coupling with the coaxial cable can be facilitated.

Further, in the endoscopic microwave irradiation instrument according to the present invention, the both-side holding member has an annular portion integrally fixed to the fixed blade, and the annular portion is located on the distal end side of the annular portion. It may have a configuration in which an open recessed portion is provided, and the insulating support portion is fitted in the recessed portion.

With this configuration, the insulating support member can be stably held.

Further, the endoscopic microwave irradiation instrument according to the present invention may have a configuration in which the sheath, which is a coil sheath having substantially the same outer diameter, is integrally connected to the annular portion.

With this configuration, for example, by using a coil sheath made of stainless steel, it is possible to ensure stable properties and operations against heat and corrosive substances during cauterization and other treatments. In addition, it becomes easier to transmit rotational torque from the operating section when adjusting the attitude of the microwave irradiation section in the rotational direction.

Further, in the endoscopic microwave irradiation instrument according to the present invention, the movable blade has teeth for preventing the tissue to be cauterized by microwave irradiation from slipping through, and the fixed blade is cauterized by microwave irradiation. It may be configured to have a coating for preventing adherence to living tissue.

With this configuration, it is possible to accurately hold the living tissue to be cauterized, and to effectively prevent the living tissue from adhering to the electrode during cauterization.

Further, in the endoscopic microwave irradiation instrument according to the present invention, the movable blade and the fixed blade may each be surface-insulated.

With this configuration, the surfaces of the movable blade and the fixed blade are insulated, respectively, so short-circuiting between the two blades can be prevented, and short-circuiting due to contact with other conductive portions can also be prevented.

ADVANTAGE OF THE INVENTION According to the present invention, there is provided an endoscopic microwave irradiation instrument capable of stabilizing the relative operating positions of a movable blade and a fixed blade and maintaining good sharpness of scissors composed of the movable blade and the fixed blade. be able to.

1 is a configuration diagram of an endoscopic microwave irradiation instrument according to an embodiment of the present invention; FIG. FIG. 2 is a sectional view taken along the line II-II of FIG. 1; 1 is a perspective view of a microwave irradiation section of a microwave irradiation instrument for an endoscope according to an embodiment of the present invention; FIG. 1 is a side view of a microwave irradiation section of a microwave irradiation instrument for an endoscope according to an embodiment of the present invention; FIG. 1 is a cross-sectional view of a microwave irradiation unit of an endoscope microwave irradiation instrument according to an embodiment of the present invention, where (a) shows a state in which a movable blade is open with respect to a fixed blade, and (b) shows a fixed state The state in which the movable blade is closed with respect to the blade is shown. Fig. 2 is a plan view of a microwave irradiation section of the endoscope microwave irradiation instrument according to the embodiment of the present invention; 4 shows a modification of the microwave irradiation unit of the endoscope microwave irradiation instrument according to the embodiment of the present invention. 4 shows another modification of the microwave irradiation section of the endoscope microwave irradiation instrument according to the embodiment of the present invention.

BEST MODE FOR CARRYING OUT THE INVENTION Hereinafter, embodiments of the present invention will be described with reference to the drawings.

An endoscopic microwave irradiation instrument 1 according to an embodiment of the present invention uses an endoscope to irradiate and heat a target tissue in the body with microwaves, thereby performing tissue cauterization, coagulation, hemostasis, and the like. In addition, the tissue is cut or excised with scissors. The microwave used has a frequency of, for example, 2450 MHz, which is higher than the frequency (several hundred MHz) of high-frequency current used in conventional high-frequency treatment instruments.

As shown in FIG. 1, the endoscopic microwave irradiation instrument 1 according to the present embodiment contains a coaxial cable 11 for energy transmission, a microwave irradiation section 30 connected to the coaxial cable 11, and the coaxial cable 11. The coil sheath 10 and the operation part 20 are provided. The coil sheath 10 is also simply referred to as the sheath 10 below. The coaxial cable 11 corresponds to the cable of the invention, and the coil sheath 10 corresponds to the sheath of the invention.

As shown in FIG. 2, the coaxial cable 11 includes a central conductor 12, a cylindrical insulator 13 surrounding the central conductor 12, an outer conductor 14 surrounding the cylindrical insulator 13, and other members such as a sheath 10. and an insulating covering portion 15 covering the outer conductor 14 for insulation. The coaxial cable 11 is inserted through the sheath 10 and can advance and retreat in the sheath 10 integrally in the axial direction.

A microwave connector 17 is connected to the proximal end 11a of the coaxial cable 11, and a microwave irradiation section 30 is connected to the distal end. Through the connector 17 and the coaxial cable 11, the microwave irradiation section 30 can be connected to a microwave power supply (not shown).

The size and material of each component of the coaxial cable 11 are set so as to be able to pass through the treatment instrument guide tube of the endoscope and to efficiently transmit desired microwaves. For example, but not limited to, the central conductor 12 is made of copper wire, copper-coated steel wire, or the like, and has a diameter of 0.2 to 0.4 mm. The tubular insulator 13 has a diameter of 0.6 to 1.2 mm, for example. The outer conductor 14 is made of copper braided wire, for example, and has a thickness of 0.08 to 0.2 mm. The thickness of the insulating coating portion 15 is, for example, 0.05 to 0.1 mm.

The sheath 10 is made of a flexible hollow tube, and in this embodiment, a conductive coil tube is used. A coil tube is a round wire coil tube formed by spirally winding a long round wire made of metal (stainless steel) or the like. The coil tube is not limited to this, and a flat wire coil tube formed by spirally winding a long flat plate made of metal (stainless steel) or the like may be used, or an inner flat coil tube may be used.

A wire tube may also be used as the sheath 10 . A wire tube is a hollow stranded tube formed by twisting a plurality of wires (cables) made of, for example, metal (stainless steel) or the like into a hollow spiral. Moreover, as the sheath 10, a wire tube may be mainly used, and only a portion of the tip side (distal end side) thereof may be a coil tube.

Alternatively, the sheath 10 may be a tube made of insulating resin. The resin material forming the sheath 10 may be an electrically insulating material such as polyethylene, polypropylene, polyvinyl chloride, polyurethane, polyamide, polyester, polycarbonate, polyethersulfone, fluororesin, and the like.

The coaxial cable 11 is inserted through the sheath 10 and is capable of rotating and sliding (sliding along the axial direction) about its axis within the sheath 10 .

The coaxial cable 11 is a power transmission that transmits a sliding force for opening and closing the scissors 31 provided in the microwave irradiation unit 30, and a rotational force that rotates the scissors 31 around the sheath axis for adjusting its posture. It functions as a member.

Although the details will be described later, the proximal end portion of the coaxial cable 11 is pulled out from the operating portion 20, and the connector 17 is attached to the proximal end thereof. At the distal end of coaxial cable 11 , center conductor 12 is connected to movable blade 33 and outer conductor 14 is connected to fixed blade 32 . Microwaves generated by a microwave power supply connected to connector 17 are sent to movable blade 33 and fixed blade 32 through coaxial cable 11 . The coaxial cable 11 functions as an energy transmission member that transmits microwave energy.

The sheath 10 functions as a power transmission member that transmits a sliding force for opening and closing the scissors 31 by sliding relative to the coaxial cable 11 . Further, although the details will be described later, the proximal end of the sheath 10 is attached to the sheath receiving portion 22c of the operation portion 20, and the distal end is connected to the holding members 36 on both sides. It works.

As shown in FIG. 1, the operating portion 20 according to the present embodiment includes a cylindrical slider portion 22, and is inserted into the slider portion 22 so as to be relatively slidable from the proximal end side and rotatable about an axis. and a base portion 21 . The base portion 21 and the slider portion 22 are mainly made of insulating resin. A reinforcing coil 16 is fixed to the distal end of the slider portion 22 so as to extend coaxially. The proximal end of the sheath 10 is inserted into the reinforcing coil 16 and is integrally fixed to the reinforcing coil 16 . That is, the sheath 10 is integrated with the slider portion 22 via the reinforcing coil 16 .

The slider portion 22 is slidably supported by the distal end portion of the base portion 21 . A portion of the coaxial cable 11 that is a predetermined distance away from the proximal end of the coaxial cable 11 inside the slider portion 22 is fixed to the base portion 21 . For this reason, the coaxial cable 11 is integral with the base portion 21 and can be slid relatively integrally with respect to the slider portion 22 . A portion of the coaxial cable 11 closer to the proximal end than the fixed portion is pulled out from the proximal end of the slider portion 22 in order to connect to an external microwave power supply.

A pair of collars 22a are formed at the proximal end of the slider part 22 so as to be separated from each other in the sliding direction. is now possible.

A finger ring portion 21a is supported at the proximal end of the base portion 21 so as to be rotatable about its axis. By inserting the thumb into the ring portion 21a while holding the circumferential groove portion 22b of the slider portion 22 between the index finger and the middle finger as described above, the operation of sliding the slider portion 22 with respect to the base portion 21 can be performed smoothly with one hand. can be done. Further, when the finger ring portion 21a is rotated, the coaxial cable 11 is rotated together with the scissors 31, which will be described later.

A resin sheath receiving portion 22 c is provided on the distal end side of the slider portion 22 . The proximal end of the sheath 10 is connected to the distal end of the sheath receiving portion 22c. The sheath 10 is supported by the sheath receiving portion 22c so as to be rotatable about its axis, and when the sheath receiving portion 22c is slid in the sliding direction, the sheath receiving portion 22c slides integrally. supported by

Next, the microwave irradiation section 30 will be described.

As shown in FIGS. 3 to 6, the microwave irradiation unit 30 has a fixed blade 32 connected to the outer conductor 14 and a movable blade 33 connected to the central conductor 12 and opening and closing with respect to the fixed blade 32. there is The fixed blade 32 and the movable blade 33 function as a pair of microwave electrodes and constitute scissors 31 for cutting living tissue.

The fixed blade 32 is made of a conductive member made of metal such as stainless steel, and has a blade surface 32a and a flat back surface 32b. As shown in FIG. 3, the blade surface 32a forms a predetermined acute angle with the back surface 32b to form a blade edge 32c. The back surface 32b forms a plane parallel to the XZ plane (see FIG. 3) and is parallel to the flat back surface 33b of the movable blade 33. As shown in FIG. The fixed blade 32 has a curved portion 32d at the lower end of the fixed blade 32 so as not to inadvertently damage body tissues. The proximal end of the fixed blade 32 is connected to the distal end of the connecting portion 36c of the holding member 36 on both sides.

The movable blade 33 is made of a conductive member made of metal such as stainless steel, and has a blade surface 33a and a flat back surface 33b. As shown in FIG. 3, the blade surface 33a forms a predetermined acute angle with the back surface 33b to form a blade edge 33c. The back surface 33b forms a plane parallel to the XZ plane (see FIG. 3) and is parallel to the back surface 32b of the fixed blade 32. As shown in FIG. A curved portion 33g is formed in the upper portion of the tip of the movable blade 33 so as not to inadvertently damage body tissues. A shaft hole 33f is formed in the proximal end of the movable blade 33 in a direction perpendicular to the XZ plane (that is, the Y direction), and a rotary shaft portion 37 such as a metal pin is inserted through the shaft hole 33f. The rotary shaft portion 37 is supported by a pair of parallel support arm portions 34a, 34a of the insulating support member 34. As shown in FIG. Specifically, both end portions of the rotating shaft portion 37 are fixed by, for example, being press-fitted into shaft holes 34c formed in the support arm portion 34a. As a result, the movable blade 33 is supported by the rotating shaft portion 37 and can rotate around the rotating shaft portion 37 .

A projecting piece 33 d for transmitting a turning force to the movable blade 33 is provided on the proximal end side of the movable blade 33 . The longitudinal direction of the movable blade 33 (the direction in which the cutting edge 33c extends) and the direction in which the projecting piece 33d extends from the proximal end of the movable blade 33 form an approximately obtuse angle. The projecting piece 33d is provided with a mounting hole 33e separated from the shaft hole 33f of the movable blade 33 by a predetermined distance. The tip of the central conductor 12 of the coaxial cable 11 is passed through the mounting hole 33e, and the central conductor 12 and the movable blade 33 are electrically connected to each other.

As shown in FIGS. 3 to 6, between the movable blade 33 and the fixed blade 32, an insulating support member 34 made of an insulating material and movably supporting the movable blade 33 in a predetermined direction and the fixed blade 32 are provided. Both side holding members 36 which are integrally formed and hold the insulating support member 34 from both sides in the direction perpendicular to the predetermined direction are interposed. The predetermined direction here is the direction of rotation about the rotating shaft portion 37 extending in the Y direction within the XZ plane. Moreover, the direction perpendicular to the predetermined direction here is the axial direction of the rotating shaft portion 37, that is, the Y direction.

The insulating support member 34 has a support base 34b and two support arms 34a, 34a provided at the distal end of the support base 34b. The two support arm portions 34a, 34a extend in the axial direction (X direction) in parallel with a space therebetween. Each support arm portion 34a is formed with a shaft hole 34c extending in a direction perpendicular to a plane parallel to the back surface 33b of the movable blade 33 (that is, the Y direction). Both ends of the rotating shaft portion 37, which is passed through the shaft hole 33f through which the movable blade 33 passes, are inserted into the shaft holes 34c of the support arm portion 34a and fixed. The opposing inner surfaces of the two support arm portions 34a, 34a are parallel, and the distance between the inner surfaces is slightly larger than the width of the movable blade 33 in the Y direction. A mounting hole 34d extending in a direction perpendicular to a plane parallel to the back surface 33b of the movable blade 33 (that is, the Y direction) is formed in the support base 34b.

Examples of the insulating material forming the insulating support member 34 include polyetheretherketone (PEEK) and ceramics.

The two-side holding member 36 is made of metal such as stainless steel, and includes a pair of parallel arm portions 36a, 36a that hold the insulating support member 34 coaxially (or in parallel) with respect to the coaxial cable 11, and both parallel arm portions 36a, 36a. It has an annular portion 36b for integrally fixing the proximal end portion of the portion 36a to the fixed blade 32. As shown in FIG.

The annular portion 36b has a cylindrical shape, the inner diameter of the annular portion 36b is larger than the outer diameter of the outer conductor 14 of the coaxial cable 11, and the outer diameter of the annular portion 36b is adjusted so as to slide smoothly inside the endoscope. The outer diameter is approximately the same as that of 10.

As shown in FIG. 5, the coaxial cable 11 has a central conductor 12 exposed by a predetermined length, a cylindrical insulator 13 exposed by a predetermined length, and an outer conductor 14 exposed by a predetermined length in order from the distal end side. Only the length is exposed. The inner surface of the annular portion 36b slides on the outer surface of the exposed outer conductor 14 of the coaxial cable 11 in an electrically conductive state.

A sheath 10, which is a coil sheath having substantially the same outer diameter, is integrally connected to the proximal end of the annular portion 36b. By using a metal coil sheath, it is possible to sufficiently follow and bend the coaxial cable 11 that is bent along the treatment instrument guide path of the endoscope, and it also functions as an electromagnetic shield for the coaxial cable 11 . In addition, since the coil sheath has a relatively high rigidity, it becomes easier to transmit rotational torque from the operation section 20 when adjusting the attitude of the microwave irradiation section 30 in the rotational direction.

The pair of parallel arm portions 36a extend axially in parallel from the distal end of the annular portion 36b, with the opposing inner surfaces separated by a distance substantially equal to the width of the insulating support member 34 in the Y direction. A notch portion 36d is provided at the distal end portion of the parallel arm portion 36a so that the end portion of the rotating shaft portion 37 inserted in the shaft hole 34c of the insulating support member 34 is exposed. This facilitates assembly of the microwave irradiation unit 30 .

A mounting hole 36e for mounting a fixture 38 (for example, a metal pin) used for fixing the insulating support member 34 is provided on the base end side of the parallel arm section 36a. A mounting hole 34d for a fixture 38 is formed in the support base 34b of the insulating support member 34 so as to correspond to the mounting hole 36e. The fixture 38 passes through the mounting hole 34d of the insulating support member 34 and is fixed in the mounting hole 36e of the both side holding member 36 by, for example, laser welding, so that the insulating support member 34 is connected to the pair of parallel arm portions 36a, 36a. It is designed to be fixed between

A coupling portion 36c extends in the axial direction from the distal end of the annular portion 36b of the both-sides holding member 36 so as to face the insulating support member 34 with a space therebetween. The proximal end of the fixed blade 32 is connected to the distal end of the connecting portion 36c. The height of the connecting portion 36c in the Z direction is smaller than the height of the fixed blade 32 in the Z direction. A conductor 12 extends.

As shown in FIG. 6, the insulating support member 34 rotatably supports the movable blade 33 by a rotating shaft portion 37 that extends between the two support arm portions 34a. The insulating support member 34 is held by a pair of parallel arm portions 36 a of both side holding members 36 from both sides in the axial direction (Y direction) of the rotating shaft portion 37 .

The movable blade 33 and the fixed blade 32 are surface-insulated. Specifically, the entire surface of each of the movable blade 33 and the fixed blade 32 is coated with an insulating coating film. The material of the insulating coating film is not particularly limited, but for example, fluorine resin, polyimide resin, ceramics, etc. are used. Examples of ceramics include metal oxides, metal nitrides, and metal carbides.

Although the film thickness of the insulating coating film is not particularly limited, it is preferably 5 to 50 μm, more preferably 5 to 15 μm. A method for forming the insulating coating film is not particularly limited, but examples thereof include a baking method, a spraying method, and an immersion method.

The insulating coating film is applied to the entire surface of the fixed blade 32 and the movable blade 33, but it is not limited to this, and may be applied to a part of the surface.

In addition, the fixed blade 32 may have a coating that prevents adherence to living tissue during cauterization by microwave irradiation. As the coating for preventing adherence to living tissue, for example, a low-adhesion insulating film such as a fluororesin can be provided. Although there is no particular limitation on the thickness of this low-adhesion insulating film, it is preferably 5 to 50 μm. There are no particular restrictions on the method of forming the low-adhesion insulating coating, and examples thereof include baking, spraying, and dipping.

The biological tissue adhesion prevention coating may be provided separately from the insulating coating film, or may be provided as a single coating film having both insulating properties and biological tissue adhesion prevention functions.

FIG. 7 shows a microwave irradiation section 30A that is a modification of the microwave irradiation section 30 of the endoscope microwave irradiation instrument 1 according to this embodiment. As shown in FIG. 7, the movable blade 33 may be formed with teeth 33h for preventing the tissue to be ablated by microwave irradiation from slipping through. The tooth portion 33h may have two or three triangular teeth formed on the tip side of the cutting edge 33c of the movable blade 33, but the shape is not limited to this and may be any shape.

Further, in the above description, the scissors 31 are configured to have the fixed blade 32 and the movable blade 33, but the configuration is not limited to this, and the scissors may be configured to have a pair of movable blades. In this case, the pair of movable blades are supported by the insulating support member so as to be capable of opening and closing, and the insulating support member is held by both side holding members in a direction perpendicular to the direction of the opening and closing motion.

Next, the operation of the microwave irradiation instrument 1 will be described.

As shown in FIG. 5B, the microwave irradiation instrument 1 is inserted into a treatment instrument guide tube (not shown) of an endoscope with the scissors 31 of the microwave irradiation section 30 closed. When the microwave irradiation section 30 reaches the vicinity of the living tissue to be treated in the body, the base section 21 of the operation section 20 is slid (downward in FIG. 1) into the slider section 22 to open the sheath. Coaxial cable 11 is slid distally within 10 . Along with this, the center conductor 12 of the coaxial cable 11 pushes the protruding piece 33d of the movable blade 33, and the rotational force (rotational force in the counterclockwise direction in FIG. give. The movable blade 33 to which the rotational force is applied rotates around the rotary shaft portion 37 to open with respect to the fixed blade 32 (see FIG. 5A).

Next, when adjusting the attitude of the scissors 31 of the microwave irradiation unit 30 in the direction of rotation about the sheath axis, the adjustment can be performed by rotating the base unit 21 with respect to the slider unit 22 .

After adjusting the posture of the scissors 31 of the microwave irradiation unit 30, slide the base unit 21 out of the slider unit 22 (upward in FIG. 1) without moving the slider unit 22 as much as possible. Then, the coaxial cable 11 is slid to the proximal end side within the sheath 10 . Along with this, the central conductor 12 of the coaxial cable 11 pulls the protruding piece 33d of the movable blade 33, giving the movable blade 33 a rotational force (clockwise rotational force in FIG. 5) with the rotary shaft portion 37 as a fulcrum. . The movable blade 33 to which the rotational force is applied rotates about the rotary shaft portion 37 as a fulcrum and tries to shift to a closed state with respect to the fixed blade 32 . By this operation, the target living tissue is temporarily gripped by the fixed blade 32 and the movable blade 33 .

In this state, by turning on the microwave power supply and supplying microwaves, the microwaves radiated between the movable blade 33 connected to the central conductor 12 and the fixed blade 32 connected to the outer conductor 14 is applied to the living tissue gripped by the fixed blade 32 and the movable blade 33 to cauterize and coagulate the living tissue to stop bleeding. Since microwaves are more likely to propagate through living tissue than through air, microwave energy can be effectively applied to the target living tissue.

After or while supplying microwaves, the base portion 21 is slid (upward in FIG. 1) so as to be pulled out further from the slider portion 22, and the movable blade 33 is rotated and fixed with the rotating shaft portion 37 as a fulcrum. Close to blade 32 . At this time, the rear surface 32b of the fixed blade 32 and the rear surface 33b of the movable blade 33 are held in contact with each other in parallel or separated from each other by a very small amount, so that they are sandwiched between the fixed blade 32 and the movable blade 33. Shear stress is applied to living tissue. By this operation, the target living tissue can be cut while the bleeding is stopped.

When the cutting treatment is completed, the scissors 31 are pulled out from the treatment instrument guide tube of the endoscope in a closed state to complete a series of operations (treatment).

Next, the effects of the endoscope microwave irradiation instrument 1 according to this embodiment will be described.

The endoscopic microwave irradiation instrument 1 according to the present embodiment is configured such that the movable blade 33 is moved from both sides in a predetermined direction (about the rotating shaft portion 37) via the insulating support member 34 by the two-side holding members 36 integrated with the fixed blade 32. (rotating direction). As a result, the relative operating positions of the movable blade 33 and the fixed blade 32 can be stabilized, and good sharpness of the scissors 31 composed of the movable blade 33 and the fixed blade 32 can be maintained.

In addition, in the endoscopic microwave irradiation instrument 1 according to the present embodiment, the two-side holding member 36 includes a pair of parallel arm portions 36a that hold the insulating support member 34 coaxially (or in parallel) with respect to the coaxial cable 11. and an annular portion 36b for integrally fixing the proximal end portions of both parallel arm portions 36a to the fixed blade 32. As shown in FIG. With this configuration, the shape can be set so that the insulating support member 34 can be stably held, and the coupling with the coaxial cable 11 is easy.

Further, the endoscopic microwave irradiation instrument 1 according to the present embodiment has a configuration in which the coil sheaths 10 having substantially the same outer diameter are integrally connected to the annular portions 36b of the holding members 36 on both sides. With this configuration, for example, by using a coil sheath made of stainless steel, it is possible to ensure stable properties and operations against heat and corrosive substances during cauterization and other treatments.

Further, in the endoscopic microwave irradiation instrument 1 according to the present embodiment, the movable blade 33 has a tooth portion 33h for preventing the tissue to be cauterized by microwave irradiation from slipping through, and the fixed blade 32 has a microwave It may have an anti-tissue adhesion coating during ablation by irradiation. With this configuration, it is possible to accurately hold the living tissue to be cauterized, and to effectively prevent the living tissue from adhering to the electrode during cauterization.

Further, the endoscope microwave irradiation instrument 1 according to the present embodiment has a configuration in which the movable blade 33 and the fixed blade 32 are each subjected to surface insulation treatment. With this configuration, it is possible to prevent short circuits between the two blades, as well as prevent short circuits due to contact with other conductive portions.

(Modification)
In the above-described embodiment, the two-side holding member 36 has a configuration in which the two parallel arm portions 36a extend axially from the annular portion 36b, but the present invention is not limited to this. FIG. 8 shows a microwave irradiation section 30B that is a modification of the microwave irradiation section 30 of the endoscope microwave irradiation instrument 1 according to this embodiment.

As shown in FIG. 8, in this modified example, the two-side holding member 36 has an annular portion 36b integrally fixed to the fixed blade 32, and the annular portion 36b opens to the distal end side of the annular portion 36b. It has a concave portion 36f, and the insulating support member 34 is fitted in the concave portion 36f. With this configuration, the insulating support member 34 can be held more stably.

In the above embodiment, the scissors 31 have the fixed blade 32 and the movable blade 33. However, the scissors may have a pair of movable blades. In this case, the pair of movable blades are supported by the insulating support member so as to be capable of opening and closing, and the insulating support member is held by both side holding members in a direction perpendicular to the direction of the opening and closing motion.

INDUSTRIAL APPLICABILITY As described above, the present invention has the effect of stabilizing the relative operating positions of the movable blade and the fixed blade and maintaining good sharpness of scissors composed of the movable blade and the fixed blade. It is useful for all microscope microwave irradiation instruments.

1 Microwave irradiation device for endoscope 10 Coil sheath (sheath)
11 coaxial cable (cable)
11a proximal end 12 central conductor 13 tubular insulator 14 outer conductor 15 insulating coating 16 reinforcing coil 17 connector 20 operating portion 21 base portion 21a finger ring portion 22 slider portion 22a collar portion 22b circumferential groove portion 22c sheath receiving portion 30, 30A, 30B microwave irradiation unit 31 scissors 32 fixed blades 32a, 33a blade surface 32b, 33b rear surface 32c, 33c blade edges 32d, 33g curved portion 33 movable blade 33d projecting pieces 33e, 36e mounting holes 33f, 34c shaft hole 33h tooth portion 34 insulating support Member 34a Support arm portion 34b Support base portion 34d Mounting hole 36 Both side holding member 36a Parallel arm portion 36b Annular portion 36c Connecting portion 36d Notch portion 36f Concave portion 37 Rotation shaft portion 38 Fixture 39 Hollow space

Claims (4)

An endoscopic microwave irradiation instrument comprising a cable for energy transmission, a microwave irradiation section connected to the cable, and a sheath housing the cable,
wherein the cable comprises a coaxial cable having a central conductor, a tubular insulator surrounding the central conductor, and an outer conductor surrounding the tubular insulator;
The microwave irradiation unit has a fixed blade connected to the outer conductor and a movable blade connected to the central conductor and opening and closing with respect to the fixed blade,
Between the movable blade and the fixed blade are an insulating support member made of an insulating material and movably supporting the movable blade in a predetermined direction, and an insulating support member integrally formed with the fixed blade. Both side holding members are interposed for holding by a holding force directed inward from both sides in a direction orthogonal to the predetermined direction ,
The two-side holding members each have opposing inner surfaces spaced apart by a distance substantially equal to the width of the insulating support member in a direction perpendicular to the predetermined direction, and the insulating support member is positioned between the opposing inner surfaces with respect to the coaxial cable. a pair of parallel arm portions that are coaxially held together, and an annular portion that integrally fixes the proximal end portions of both parallel arm portions to the fixed blade. instrument. 2. The endoscope microwave irradiation instrument according to claim 1 , wherein the sheath, which is a coil sheath having substantially the same outer diameter, is integrally connected to the annular portion. The movable blade has a tooth portion formed on the cutting edge of the movable blade for preventing the tissue to be ablated by microwave irradiation from slipping through,
3. The microwave irradiation instrument for an endoscope according to claim 1 , wherein said fixed blade has a coating for preventing adherence of living tissue during cauterization by microwave irradiation. 4. The endoscope microwave irradiation instrument according to any one of claims 1 to 3 , wherein the movable blade and the fixed blade are surface-insulated.

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