JPH0313898B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to a high-frequency incision tool that is inserted endoscopically into a body cavity to incise the duodenal papilla and the like.

[Conventional technology]

For example, a high-frequency incision tool is known that uses high-frequency waves to incise the duodenal papilla when the bile duct is obstructed.

For example, as shown in Japanese Patent Laid-Open No. 60-29141, a knife wire is exposed along the outer surface near the tip of a flexible tube that can be inserted into an insertion channel of an endoscope. A high-frequency incision is formed at the exposed portion of the knife wire, and by applying a high-frequency current for cauterization to the incision through the knife wire, a high-frequency incision is made on, for example, the duodenal papilla. ing. In this case, the distal end of the flexible tube is inserted into the bile duct, and one way to confirm that the distal end of the flexible tube is inserted into the bile duct is to aspirate bile through the flexible tube. There is. Therefore, an opening is provided in the side wall near the tip of the flexible tube and bile is sucked through this opening, but in order to prevent the flexible tube from bending at this tip, a reinforcing wire is installed to prevent the flexible tube from bending. It's decorated.

[Problem that the invention seeks to solve]

In the prior art, when the reinforcing wire provided to reinforce the distal end of the flexible tube is bent due to an operation such as raising the forceps of an endoscope, the reinforcing wire may break. There is a risk that this broken reinforcing wire may fall into the body cavity through the opening at the distal end of the flexible tube or the opening provided in the side wall.

This invention was made with attention to such a problem, and even if the reinforcing wire that reinforces the vicinity of the distal end of a flexible tube having an incision is broken in the middle, it will not fall off from the flexible tube. , aiming to improve safety.

[Means and actions for solving problems]

This high-frequency incision tool exposes an incision 6 for cauterization on the outer surface near the tip of an insulating flexible tube 1, and applies a high-frequency current to this incision 6 to incise the duodenal papilla, etc. A stopper 9a is provided at the tip of a reinforcing wire 9 made of a wire rod stretched in the axial direction that reinforces the vicinity of the tip of the flexible tube 1, so that even if the reinforcing wire 9 is broken halfway due to bending of the flexible tube 1, the stopper 9a is provided. held within the flexible tube 1 by 9a;
Prevent it from falling outside the flexible tube 1.

Examples Examples of this study will be described below based on the drawings.

1 to 4 show the first embodiment,
FIG. 1 shows the overall structure of the high-frequency incision tool. Reference numeral 1 denotes a flexible tube made of an electrically insulating material, and the flexible tube 1 can be inserted into an insertion channel of an endoscope, which will be described later.
A hand operation section 3 is connected to the base end of the flexible tube 1 via a suction section 2, and a slider 4 for pushing and pulling a knife wire, which will be described later, is connected to the hand operation section 3.
is provided. The slider 4 is electrically connected to a high frequency generator (not shown) for supplying high frequency current by a cord (not shown). Further, a suction device (not shown) such as a syringe is connected to the suction unit 2 so as to suction through the flexible tube 1 .

Further, a part of the knife wire 5 housed in the flexible tube 1 is inserted near the tip of the flexible tube 1.
An incision 6 is provided by exposing the outside. The cutout 6 is formed by two outlet holes 8 formed in one side wall of the flexible tube 1 spaced apart in the front and rear direction, through which the knife wire 5, one end of which is fixed to the wire attachment tube 7 fixed inside the flexible tube 1, is inserted. , 8 to the outside of the flexible tube 1 and exposed. Further, a reinforcing wire 9 is fixed to the wire attachment tube 7 so as to extend in the axial direction of the flexible tube 1 and to reinforce the flexible tube 1 near the incision 6. By bending the reinforcing wire 9 into a substantially U-shape, a wide stopper 9a is formed at the distal end of the reinforcing wire 9.
a and the opening 11 so as not to fall off. In addition, the flexible tube 1 near the incision 6
A plurality of markings 10 are provided at equal intervals on the outer surface.

Furthermore, a tip opening 1 is provided at the tip of the flexible tube 1.
a, and a suction opening 11 is provided on the side of the incision 6 in the vicinity of the most distal end. Further, on the inner wall of the flexible tube 1 corresponding to this opening 11, a reinforcing member 12 made of a metal pipe is provided.
is installed. This reinforcing member 12 has an opening 13 formed by a cutout hole facing the opening 11 of the flexible tube 1.
is provided so that bile can be sucked through the opening 11.

Next, the operation of the high-frequency incision tool configured as described above will be explained.

First, a high-frequency cutting instrument is inserted into the insertion channel of the endoscope 14 and inserted into the body cavity, and the distal end of the flexible tube 1 is made to protrude from the distal end component 15 of the endoscope 14 . Then, the distal end of the flexible tube 1 is inserted into the bile duct c from the papilla b of the duodenum a. Here, suction part 2
A suction device such as a syringe is attached to the tube, and the bile is aspirated from the opening 11 through the flexible tube 1, and the endoscope 14 confirms that it is bile, that is, that the tip of the flexible tube 1 has been inserted into the bile duct c. Check. At this time, even if the vicinity of the incision 6 of the flexible tube 1 is bent due to repeated operations such as raising the forceps of the endoscope, and the reinforcing wire 9 inserted inside is cut from the middle due to this bending, the reinforcing wire 9 Since a stopper 9a larger than the distal end opening 1a and the opening 11 is provided at the distal end of the reinforcing wire 9, the reinforcing wire 9 will not fall out of the flexible tube 1 into the body cavity.

Next, when the slider 4 provided on the hand control unit 3 is pulled, the knife wire 5 is pulled, the incision 6 becomes straight and comes into contact with the papilla b, and the flexible tube 1 curves. In this state, when the high frequency generator is operated to supply a high frequency current, the papilla b can be incised with high frequency. Note that if the flexible tube 1 is accidentally inserted into the pancreatic duct d, the bile will not be aspirated even if the flexible tube 1 is suctioned with a suction device, and it can be confirmed that the flexible tube 1 has not been inserted into the bile duct c. Errors can be confirmed before the high-frequency current is applied, and the risk of making an incision in a region other than the intended region can be prevented.

FIG. 5 shows a second embodiment, in which a pipe-shaped stopper 16 is provided at the tip of the reinforcing wire 9 to be inserted into the flexible tube 1.

FIG. 6 shows a second embodiment, in which the tip of the reinforcing wire 9 is bent into a substantially S-shape to form an elastic stopper 17, and this elastic force allows the tip to be bent into a flexible tube. 1 and reinforcing wire 9.
Even if the flexible tube 11 is cut from the middle, the cut piece does not move and is prevented from falling out of the flexible tube 11.

FIG. 7 shows a fourth embodiment, in which, for the same purpose as the third embodiment, a stopper 18 is formed by bending the tip of the reinforcing wire 9 into a loop shape to provide elasticity.
The flexible tube 1 has a tip that bites into the inner surface of the flexible tube 1.

[Effects of the Invention] As explained above, according to the present invention, a stopper that cannot pass through the opening of the flexible tube is provided at the tip of the reinforcing wire that reinforces the vicinity of the tip of the flexible tube having the incision, Even if the internal reinforcing wire is cut midway due to bending of the flexible tube, it will not fall off into the body cavity outside the flexible tube, resulting in an effect that safety can be improved.

[Brief explanation of the drawing]

1 to 4 show a first embodiment of the present invention, and FIG. 1 is an overall view of the high-frequency cutting tool, and FIG.
The figure is a longitudinal cross-sectional side view of the tip, Figures 3 and 4.
The figure is a cross-sectional view showing the incision state of the papilla, FIG. 5 is a longitudinal side view of the tip of the flexible tube showing the second embodiment, and FIG. 6 is a side view of the tip of the flexible tube showing the third embodiment. FIG. 7 is a vertical side view of the tip of the flexible tube showing the fourth embodiment. 1...Flexible tube, 2...Suction part, 3...Hand control part, 5
... knife wire, 6 ... incision, 9 ... reinforcement wire,
9a, 16, 17, 18...stopper, 11...opening.

Claims (1)

[Claims] 1. One end is fixed inside the tip of an insulating flexible tube,
A knife wire has an incision for cauterization exposed on the outer surface near the distal end on the rear end side of the fixed part, and the knife wire is energized with a high-frequency current for cauterization, and the tip is inserted into the flexible tube from the fixed part. A reinforcing wire made of a wire extending in the axial direction and extending toward the distal end and reinforcing the flexible tube near the incision, an opening near the distal end of the flexible tube and a suction section on the proximal side of the knife wire. In a high-frequency cutting tool having an operation part,
A high-frequency cutting tool characterized in that a stopper having an outer diameter larger than the opening is provided at the tip of the reinforcing wire. 2. The high-frequency cutting tool according to claim 1, wherein the stopper has an elastic end portion that bites into the inner surface of the flexible tube.