JPH04361744A - High frequency excision and severance tool - Google Patents

Abstract

PURPOSE:To provide a safe high-frequency excision and severance tool used in strip biopsy, which is easy to manufacture and with which tying can be made easily and certainly. CONSTITUTION:A slip preventive chip 9 is provided with tapers 9b, 9e at the tail and fixed to an excision wire 8. The tapers are so arranged as to face the outside and inside of a loop of excision wire 8.

Description

[Detailed description of the invention]

0001

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a high-frequency cutting and cutting instrument, such as a high-frequency snare, which is inserted endoscopically into a body cavity and cuts and removes a lesion within the body cavity using a high-frequency current.

0002

2. Description of the Related Art Hitherto, high-frequency snares have been used for polypectomy, but in recent years, strip biopsy, a new procedure using high-frequency snares, has become popular. An overview of strip biopsy is given below.

[0003] Strip biopsy is suitable for flat lesions, and by locally injecting physiological saline into the submucosa layer directly below the flat lesion using an endoscopic injection needle,
This involves elevating a flat lesion, applying a high-frequency snare loop to it, and cutting out the entire lesion along with the surrounding normal tissue at once using a high-frequency current.

[0004] In strip biopsy, the lesion can be excised cleanly, including the surrounding normal tissue, so the resected piece is inspected and if the lesion is completely localized within the resected piece, the lesion is identified. It is confirmed that the tumor was completely excised. Such strip biopsy has become rapidly popular in recent years as it enables complete endoscopic treatment of early-stage cancer, and expectations are high.

However, when performing this strip biopsy, when using a normal high-frequency snare, the loop of the snare slips when it is hung over a lesion raised by local injection of physiological saline, making it difficult to bind the snare. There is a problem. In other words, even if a flat lesion is raised with physiological saline, the raised part is gentler than the polyp targeted by conventional high-frequency snares, and the loop may slip when tied up.

[0006] In order to solve this problem, if an endoscopic treatment instrument is used which has a non-slip element inside a loop formed of a band-shaped material, as shown in West German Patent Publication DE 3717658A1, the above-mentioned problem can be solved. The problem of the loop slipping and not being able to bondage may be solved.

[0007]

[Problems to be Solved by the Invention] However, when performing high-frequency incision and resection using the treatment instrument shown in West German Patent Publication DE 3717658A1, since the loop portion of the snare is made of a band-shaped material, The contact area between the loop and the tissue increases,
Current density does not increase and incision cannot be made. At this time, if you try to force the incision and apply electricity for a long time or increase the output of the high-frequency power source unnecessarily, perforation may occur, which is extremely dangerous. In addition, the above-mentioned West German Patent Publication DE
In the treatment tool shown in No. 3717658A1,
It is difficult to manufacture because anti-slip elements such as protrusions are formed on the strip-shaped material.

[0008] Accordingly, an object of the present invention is to provide a high-frequency incision and cutting tool that is easy to bind, can be securely bound, is safe, and is easy to manufacture in strip biopsy.

[0009]

[Means for Solving the Problems] The present invention includes a flexible tube, an operating member inserted into the flexible tube so as to be freely retractable, and a distal end of the operating member capable of protruding and retracting from the distal end of the flexible tube. The anti-slip tip is provided with a treatment section formed by forming an incision wire on a loop and fixed by caulking. The structure is tapered inward and outward.

0010

[Operation] With the above structure, the tip becomes non-slip, and the lesion can be securely bound by the incision wire.

[0011]

DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment of the present invention will be described below with reference to FIGS. 1 to 5.

FIG. 3 shows a high-frequency snare as a high-frequency incision and cutting tool of the present invention, and 1 is a flexible tube. This flexible tube 1
An operating section 2 is provided at the base end of the
and a slider 4 slidably attached to the base 3. An operating wire 6 is inserted through the electrode 5 of the slider 4 into the flexible tube 1 so as to be able to move forward and backward.
The proximal ends of are connected. Further, a high frequency power source (not shown) is connected to this electrode 5.

A connecting tip 7 is provided at the tip of the operating wire 6.
is attached, and both ends of an incision wire 8 are connected to this connection tip 7. This incision wire 8 has a habit of opening in a loop shape in advance, and when it is pulled into the flexible tube 1, it is elastically deformed and crushed into a long and thin shape, and when it is pushed out from the tip of the flexible tube 1, It spreads out in a loop.

[0014]The front half of the incision wire 8 includes:
As shown in FIG. 1, a plurality of anti-slip tips 9 are attached at intervals, thereby forming a treatment section 10.

The chip 9 is formed of a plate material processed by photo-etching, wire cutting, pressing, etc., and has a side plate portion 9 bent into a U-shape as shown in FIG.
d, and a protrusion 9a protruding from the tip 9c of the U-shaped recess in the direction opposite to the bending direction of the side plate 9d, and the rear end of the tip 9 has a taper on the outside and inside of the loop. 9b,
9e.

As shown in FIG. 4, the incision wire 8 is inserted into the U-shaped recess and fixed by caulking the side plate 9d with the protrusion 9a facing inside the loop.

In order to excise the lesion A shown in FIG. 5 using the high-frequency snare having such a structure, the flexible tube 1 is first inserted endoscopically into the body cavity. Next, when a lesion is found through endoscopic observation, the slider 4 of the operating section 2 is operated forward to cause the incision wire 8 to protrude from the tip of the flexible tube 1 and spread into a loop shape.

In this state, the incision wire 8 is placed over the lesion that has been raised with physiological saline, and the slider 4 is moved back to pull the wire 8 into the flexible tube 1, thereby removing the lesion using the wire 8. Tighten with. If a high frequency current is applied to the incision wire 8 in this state, the lesion sandwiched between the wires can be excised.

At this time, the protrusions 9a of the tips 9, which are caulked and fixed to the incision wire 8 constituting the treatment section 10, become non-slip, and even a lesion with a small protrusion can be easily and reliably bound. be able to. Furthermore, since the treatment section 10, which corresponds to the loop of the snare, is composed of the incision wire 8, a high current density can be obtained between the wire 8 and the tissue. Excision can be performed.

Furthermore, since the anti-slip tip 9 can be manufactured by pressing or the like, and the anti-slip tip 9 is fixed by caulking to the cutting wire 8, the high frequency snare can be manufactured easily and inexpensively. can do. Further, since the tip 9 has a taper 9b, the incision wire 8 can be drawn smoothly into the flexible tube 1 without the side plate portion 9d getting caught on the tube when binding the lesion.

Furthermore, since the tip 9 has a taper 9e on the inside of the loop, even if the incision wire 8 is twisted when binding the lesion, the tip of the flexible tube 1 will remain intact as shown in FIG. It can be pulled in smoothly without getting caught.

FIGS. 6 and 7 show a second embodiment of the invention. In this embodiment, the mounting position of the anti-slip tips 9 is changed, and the wires are fixed so that the tips 9 are displaced from each other when the incision wire 8 is drawn into the flexible tube 1, as shown in FIG. The mounting position of the chip 9 is adjusted on both sides of the chip 8.

In addition to the other basic structure and operation of the first embodiment, since the tips 9 are displaced from each other when the incision wire 8 is drawn into the flexible tube 1, the wire 8
can be drawn in smoothly.

FIG. 8 shows a third embodiment of the invention. In this embodiment, after the anti-slip tip 9 is caulked and fixed, it is fixed to the connecting portion between the tip 9 and the wire 8 by brazing or the like to form a welded portion 11.

The other basic configuration and operation are the same as those of the first embodiment, but the effect of providing the welded portion 11 is that the rear end side of the tip 9 is
The difference in level between the wire 8 and the wire 8 is completely eliminated, and the wire 8 can be drawn into the tube 1 very smoothly.

Furthermore, even if the strands of the wire 8 are cut due to too strong crimping force when crimping the tip 9, the welded portion 1
1, and even if the caulking force is too weak, the welded portion 11 provides a large connection strength. In other words, there is no problem even if the crimping force varies, and the crimping work can be easily performed.

[0027]

As described above, according to the present invention, the protrusion and tapered tip fixed by caulking to the incision wire constituting the treatment area become non-slip, making it easy to bind lesions with small protrusions. And it can be done reliably.

Furthermore, since the treatment section corresponding to the loop of the snare is composed of an incision wire, a high current density can be obtained between the incision wire and the tissue. Open excision can be performed.

Furthermore, since the anti-slip tip is caulked and fixed to the incision wire, the high-frequency cutting and cutting tool can be manufactured easily and at low cost.

[0030] Furthermore, the tip can be smoothly pulled in without being caught on the tip of the flexible tube during binding.

[Brief explanation of the drawing]

FIG. 1 is an enlarged cross-sectional view of the tip of a high-frequency snare according to a first embodiment of the present invention.

FIGS. 2A and 2B are views of the anti-slip tip of the first embodiment, respectively, viewed from the front and back directions.

FIG. 3 is an overall view of a high frequency snare according to the first embodiment of the present invention.

FIG. 4 is a diagram showing a state in which the anti-slip tip according to the first embodiment of the present invention is attached.

FIG. 5 is a diagram showing a high-frequency snare hooked onto a lesion.

FIG. 6 is an enlarged cross-sectional view of the tip of a high-frequency snare according to a second embodiment of the present invention.

FIG. 7 is a diagram showing the high frequency snare of the second embodiment drawn into the flexible tube.

FIG. 8 is an enlarged cross-sectional view of the tip of a high-frequency snare according to a third embodiment of the present invention.

[Explanation of symbols]

1 Flexible tube 2 Operation section 3 Base 4 Slider 5 Electrode 6 Operation wire 7 Connection chip 8 Incision wire 9. Anti-slip tip 9a Protrusion 9b taper 9c Tip 9d Side plate part 9e Taper 10 Treatment department 11 Welded part

Claims (1)

[Claims] Claim 1: A flexible tube, an operating member inserted into the flexible tube so as to be freely advanced and retractable, and an anti-slip tip provided at the tip of the operating member so as to be able to protrude and retract from the tip of the flexible tube. The anti-slip tip has a protrusion on the distal end and a protrusion on the rear end that tapers inward and outward with respect to the loop. 1. A high-frequency incision and resection tool comprising: