JPH0351178B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to a stone crushing device for crushing stones formed within a body cavity.

[Conventional technology]

Bonds that occur in organs such as the biliary tract or bladder have a negative impact on the patient. In particular, enlarged stones cause extremely great pain to patients.

Therefore, as a treatment for this, a stone crushing device is used endoscopically to crush the stone generated in the body cavity and discharge or remove it from the body.

As shown in FIG. 10, this type of stone crushing device is equipped with a basket 1 made up of a plurality of elastic wires at the tip of an operating wire 2, and this basket 1, together with the operating wire 2, has a hard part at the tip. Some devices have an operating rod 3 that is inserted into a flexible sheath and moves the operating wire forward and backward from the rear end. Then, when this stone crushing device is endoscopically inserted into a body cavity and a stone is grasped with the basket 1 protruding from the tip of the flexible sheath by operating the operating wire 2, the above-mentioned basket 1 is The stone is pulled into a flexible sheath and reduced in size, thereby crushing the stone into fine pieces. (Utility Model Application No. 55-34810) [Problems to be Solved by the Invention] However, in such a stone crushing device, the operating wire 2 and the operating rod 3 that advance and retreat within the flexible sheath are not strong enough. No weak spots were identified. Therefore, when the stone is grasped by the basket 1 and the operating wire 2 is pulled to draw the basket 1 into the flexible sheath to perform lithotripsy, if the stone is hard, the fixing groove 3a at the end of the operating rod 3 is used to crush the stone. It may break. If the end of the operating rod 3 is broken in this manner, the operating wire 2 cannot be operated, and the stone remains grasped. At this time, as an emergency measure,
The flexible sheath is removed from the operating wire 2, and only the endoscope is removed from the body cavity, leaving the operating wire 2 in the body cavity. However, the operating rod 3, which is a long hard part,
remains at the rear end of the operating wire 2, so this operating rod 3
could not pass through the forceps channel of the endoscope, and the endoscope could not be removed. In addition, as another breakage point, the operating wire may be broken in the middle, and in this case, the breakage point may not be exposed to the outside, and there is a risk that operation may become impossible.

The present invention has been made in view of the above-mentioned problems, and an object of the present invention is to provide a stone crushing device in which stones are hard and a long hard part does not remain with respect to the operation wire when the stone crushing device breaks. purpose.

[Means for solving problems]

As shown in FIG. 1, this invention fixes a coupling member 3 at the proximal end of an operating wire 2 having a basket 1 at its tip, and inserts the coupling member 3 into a flexible sheath 4 so as to be slidable. A coupling member 3 is connected to a sliding operation part 5 provided at the proximal end of the flexible sheath 4. The coupling member 3 has a separating portion 6 that separates when a certain amount of force is applied near the connection point with the operating wire 2.

[Effect]

In this invention, the basket 1 is opened and closed via the operation wire 2 by advancing and retracting the sliding operation part 5,
After the stone is grasped in the basket 1, lithotripsy is performed. At this time, if the stone is hard and cannot be crushed and a certain amount of operating force is applied, the operating wire 2 and the connecting member 3
and are separated.

〔Example〕

FIGS. 2 to 4 are diagrams explaining a first embodiment of the present invention. The stone crushing device shown in FIG. 2 is equipped with a flexible sheath 4 made of a tightly wound coil or the like. A cylindrical hard part 12 is attached to the tip of the flexible sheath 4, and a base 13 is attached to the base. As shown in FIG. 3, this cap 13 consists of a first member 15 having a liquid feeding port body 14 and a second member 16 screwed to this first member 15. A through hole 17 passing through in the axial direction is coaxially bored in the. A liquid-tight tube 18 which is inserted into the flexible sheath 4 and made of a material such as fluororesin is connected to the first member 15 so as to communicate with the through hole 17 . Therefore, a syringe (not shown) can be connected to the liquid feeding port body 14 to flow a liquid such as a contrast medium into the liquid-tight tube 18.

The operating wire 2 is inserted through the flexible sheath 4. A basket 1 is provided at the tip of the operating wire 2. This basket 1 has a plurality of elastic wires 21 whose front and rear ends are each connected by a tip 22, and a bent part 23 is formed in the middle.
The operating wire 2 has a cage shape that can be expanded and contracted in the axial direction, that is, can be opened and closed.

The tip of a straight rod-shaped coupling member 3 is fixed to the base end of the operating wire 2 . A V-groove 7 serving as a separating portion is formed on the outer periphery of the coupling member 3 near the connection point on the operating wire 2 side. The coupling member 3 is slidably inserted into the through hole 17 of the base 13, and its base end protrudes from the second member 16. Note that the first member 15 and the second member of the base 13 are
An O-ring 25 is provided at the joint with the member 16, and the coupling member 3 is passed through the O-ring 25 so that the through hole 17 is maintained liquid-tight.
The operating wire 2 and the basket 1 are connected to a flexible sheath 4
It can be pulled out more.

On the other hand, the base 13 is detachably connected to the operating section 26. As shown in FIG. 2, the operating section 26 has a main body 27, and a grip section 28 for the operator to grasp is integrally formed at the tip of the main body 27. An insertion hole 29 is formed coaxially through the main body 27 and the grip part 28, and the grip part 28
The second member 1 of the base 13 is attached to the ring body 30 at the tip of the
6 into the groove 16 formed on the outer circumferential surface of the second member 16 by screwing in the setscrew 31.
By engaging with a, the cap 13 can be connected to the operating section 26. Insertion hole 29 of the operating section 26
A rack body 32 having a circular cross section is slidably inserted into the housing, and a rack 33 is formed on the outer surface of one radial end of the rack body 32 over almost the entire length in the axial direction. Further, a guide groove 34 that is open to the other end in the radial direction is formed at a location other than both ends in the axial direction, and a through hole 35 that communicates with the guide groove 34 is formed in both ends in the axial direction. The coupling member 3 protrudes from the second member 16 of the base 13 connected to the operating section 26.
The proximal end portion of the rack body 32 is inserted into the through hole 35 and the guide groove 34, and the distal end thereof protrudes from the proximal end of the rack body 32. Note that the rack body 32 is connected to the operating section 26.
Rotation is prevented by a guide screw 36 screwed onto the main body 27 and engaged with a guide groove 34.

A grip portion 37 is connected to the base end of the rack body 32. A mounting hole 38 is formed in this grip portion 37 coaxially with the coupling member 3 inserted into the operating portion 26 . The end of the coupling member 3 in which the fixing groove 3a is formed is inserted into the attachment hole 38. Furthermore, a storage hole 39 is formed in the grip portion 37 in the radial direction, intersecting with the attachment hole 38 . This storage hole 39
is provided with a fixing rod 43 having an engagement hole 41 penetrating radially in the middle of the axial direction and having a button 42 attached to the upper end and biased in the projecting direction by a spring 44. Therefore, the fixing rod 43 is pushed in against the spring 44, and with its engagement hole 41 facing the mounting hole 38, the end of the coupling member 3 is inserted into the mounting hole 38, and the fixing groove 3a is inserted. Engagement hole 4
1 and then release the pressure on the fixing rod 43, the fixing groove 3a and the fixing rod 43 will engage, and the coupling member 3 will be fixed to the grip part 37. Therefore, the operating wire 2 can be moved forward and backward by the grip portion 37 via the coupling member 3.

The main body 27 of the operating section 26 has a first support shaft 45 having a handle in a direction perpendicular to the rack body 32.
is rotatably supported. Further, the main body 27 rotatably supports a second support shaft 46 whose axis is parallel to the first support shaft 35 . At one end of the second support shaft 46, a gear is provided that meshes with the gear provided on the first support shaft and has more teeth than that gear. The part corresponding to the middle part of the second support shaft 49 of the main body 27 is a housing part 4 that is open to the guide groove 34.
7 is formed. A gear 48 fitted onto the second support shaft 46 is provided in the housing portion 47, and this gear 48 meshes with the rack 33. Therefore, when the handle is rotated, this rotation is decelerated and transmitted to the gear 48, which moves the rack body 32 forward and backward, and connects the operating wire 2 thereto via the coupling member 3. Can be linked.

The proximal end of the flexible sheath 4 is protected by a cover 49 attached to the base 13, as shown in FIG.

Next, how to use the device having the above structure will be explained. First, with the operating part 26 removed from the base 13, the flexible sheath 1 is endoscopically introduced into the body cavity, and is protruded from the tip of the endoscope and inserted into the bile duct, for example, from the duodenal papilla. . Next, the operation section 26 is connected and fixed to the base 13. In other words,
The proximal end of the coupling member 3 is fixed to the grip part 37 with a fixing rod 43, and the second member 16 of the cap 13 is fitted into the ring body 30 and fixed with a set screw 31.

Next, when the inside of the bile duct is observed through the endoscope and a stone is found, the handle 37 is pushed in, and the operation wire 2 is advanced together with the rack body 32 to move the basket 1 to the tip of the flexible sheath 4. Let it protrude and open. When the basket 1 is opened in this manner, stones are taken into the basket through the gap between the elastic wires 21, and then the gripping portion 37 is moved to the rear end to retract the basket 1.

If the stone held in the basket 1 in this way is too large to be removed from the bile duct, the handle of the operating section 26 should be moved to the rack body 32.
When the basket rotates in the backward direction, the operation wire 2 is linked to the movement of the rack body 32 to draw the basket 1 into the flexible sheath 4 and contract it.
The calculus is compressed and crushed by the elastic wire 21 of the basket 1.

At this time, the stone is hard and cannot be crushed, so the operating section 2
When a large amount of operating force is applied at step 6, the coupling member 3 breaks at the V-groove 7 near the connection point with the operating wire 2. This is because the amount of cutting force in the V-groove 7 in the coupling member 3 is made smaller than the amount of cutting force in other parts of the coupling member 3.

Therefore, since the hard coupling member 3 separates from the operating wire 2 at the time of breakage, the endoscope can be removed after the flexible sheath 4 is removed from the operating wire 2.

Incidentally, in the above embodiment, the V-groove 7 may be a notched groove 8 as shown in FIG.

Next, a second embodiment of the present invention will be described based on FIGS. 6 and 7. This second embodiment differs only in the connection structure between the operating wire 2 and the coupling member 3.
The base end of the operating wire 2 is connected to the fitting ring 50 by brazing or the like, and the fitting ring 50 is further connected to the end of the coupling member 3 by brazing or the like. This fitting ring 50
has a notch 51 on the outer periphery. Note that this notch 51 may be provided at one or more locations.

Even in this second embodiment, if a large amount of operating force is applied during use and the stone does not break, the fitting ring 50
The endoscope can be removed from the notch 51 in the same manner as in the first embodiment.

FIGS. 8 and 9 are diagrams showing a third embodiment of the present invention. In the third embodiment, the proximal end of the operating wire 2 is tied to form a knot 52. This knot 52 is covered with a cap 54 having a through hole 53 through which the knot 52 cannot pass, and this cap 54 is connected to the end of the coupling member 3 to connect the operating wire 2 and the coupling member 3. Fixed.

In this third embodiment, when a large amount of operating force is applied during use and the stone does not fracture, the tuberosity 52 is tightened and becomes smaller, and the through hole 53 of the cap 54
It passes through and comes off, allowing the endoscope to be removed.

〔Effect of the invention〕

According to this invention, the separation part that separates when a certain amount of force is applied to the connecting member of the stone crushing device is provided near the operating wire connection end, so that when the stone is hard during stone crushing and a certain amount of operation force is applied, the separation part will separate. The two separate from each other. Therefore, almost no hard part remains on the proximal end side of the operating wire, and the endoscope can be removed.

[Brief explanation of drawings]

Fig. 1 is a diagram for explaining the present invention, Figs. 2 to 4 are diagrams showing a first embodiment of the invention, Fig. 2 is an overall view of the stone crushing device, and Fig. 3 is a flexible 4 is a cross-sectional view of the main part of the operating wire, FIG. 5 is a view showing a modification of the first embodiment, and FIG. 6 is a cross-sectional view of the sheath.
The drawings show a second embodiment of the invention, FIG. 7 is a perspective view showing the main parts of the second embodiment, FIG. 8 shows a third embodiment of the invention, and FIG. 9 shows a third embodiment of the invention. FIG. 10 is a perspective view showing main parts of the embodiment, and FIG. 10 is a diagram showing a conventional example. DESCRIPTION OF SYMBOLS 1...basket, 2...operating wire, 3...coupling member, 4...flexible sheath, 6...separation part.

Claims (1)

[Scope of Claims] 1. A basket comprising a flexible sheath, an operating wire slidably inserted through the flexible sheath, a plurality of elastic wires connected to the tip of the operating wire, and the operating wire. In a stone crushing device comprising a sliding operation part connected to a proximal end of a wire, a hard connecting member is provided continuously to the operating wire so as to be connected to the sliding operation part, and A stone crushing device characterized in that a separating part is provided near a connection point with an operating wire, the cutting force of which is smaller than that of other parts. 2. The bonding and crushing device according to claim 1, wherein the separation part has a notch on its outer periphery and is comprised of fitting rings that connect the operating wire and the coupling member at both ends. 3. The stone crushing device according to claim 1, wherein the separating section comprises a cap through which an operating wire is passed and whose proximal end is held at the end of the connecting member as a nodule.