JPH05161600A - Treating device for endoscope - Google Patents

Abstract

PURPOSE:To prevent peeling of an external tube which covers an internal sheath especially composing an inserting part of a treating device and mutual deviation therebetween though with a simple construction. CONSTITUTION:The outer circumference of a flexible internal sheath 5 made of a metal coil is covered with a tube 6 by an extrusion molding of a resin and the tube 6 is fixed closely on the outer circumference of the internal sheath 5. In this manner since the tube 6 is fixed closely on the outer circumference of the internal sheath 5 by the extrusion molding of a synthetic resin, a closely fixing strength therebetween increases. This can prevent easy peeling of the fixed part between the both parts otherwise caused by a tension which will work on the external tube 6 during the use, heat during a high frequency energization and the like and exposure of the metal internal sheath 5 because of a deviation between both the parts.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscopic treatment instrument such as a high-frequency snare or grasping forceps used endoscopically.

[0002]

2. Description of the Related Art Generally, an insertion portion of a treatment instrument for an endoscope is constructed by coating a resin tube on the outer periphery of a sheath made of a closely wound metal coil. For example, a high-frequency treatment instrument for an endoscope known in Japanese Patent Laid-Open No. 1-204664 is a high-frequency treatment instrument that applies a high frequency to perform a treatment such as cautery incision on a site inside a body cavity.
This insertion part is also formed by covering the outer circumference of a sheath made of a closely wound metal coil with an electrically insulating tube.

[0003]

However, in general, the insertion portion of the endoscopic treatment tool is of a type in which the outer periphery of the inner sheath is simply covered with a tube and fixed. Further, in the case of Japanese Patent Laid-Open No. 1-264664,
The outer sheath has a structure in which at least the tip portion of the outer sheath is intimately fixed to the outer periphery of the inner sheath by thermoforming so as to integrate the two, but the fixing strength between them is not so large. For this reason, when it is used for a long time with considerable frequency, there is a possibility that the adhered portions of the both may come off.

In particular, in this type of endoscopic treatment tool, there are the following special usage situations, and therefore there is a situation in which the fixed portions of the two are particularly likely to come off. That is, it is used by being inserted into the body cavity through the treatment instrument insertion channel of the endoscope that has been inserted into the body cavity in advance, and at that time, the state in which the treatment instrument insertion channel of the endoscope loops Along with this, the endoscopic treatment tool is also curved.

At this time, due to the difference in the radius of curvature between the inner sheath and the outer sheath, the inner sheath relatively expands and a tensile force is applied to the outer sheath. Therefore, during use, the inner sheath and the outer sheath are Forces that are displaced from each other are generated, and the adhered portions of the two are easily peeled off. In particular, if the fixing strength of the distal end portion of the bending portion of the endoscope that receives the bending action is small, the distal end portion of the inner sheath may be easily peeled off, and as a result, the distal end portion of the inner sheath may be exposed outside the distal end of the outer sheath. is there.

In the case of the high-frequency treatment instrument, there is a risk that the exposed metal portion of the tip of the inner sheath may burn a portion other than the target portion, so that sufficient caution is required. further,
Due to the heat generated when processing is performed using high frequency, the strength for fixing the inner sheath and the outer sheath gradually decreases, and there is a drawback in that the fixing portions of both of them become easier to separate.

In view of the above, the present invention has a simple structure, and in particular, prevents the outer tube covered by the inner sheath constituting the insertion portion of the treatment instrument from being peeled off and displaced from each other. An object is to provide a treatment tool for an endoscope.

[0008]

A treatment instrument for an endoscope according to the present invention has a flexible inner sheath made of a metal coil, which is covered with a tube by resin extrusion molding. A tube is closely fixed to the outer circumference. In this way, the tube is tightly fixed and formed by extruding a synthetic resin around the outer circumference of the inner sheath, so that the tight fixing strength between the tubes is increased, and pulling to the outer tube during use or during high frequency energization It is possible to prevent the fixing portion between the two from being easily peeled off by heat or the like, and the metal inner sheath being exposed due to the displacement of the both.

[0009]

1 and 2 show a first embodiment of the present invention. This embodiment relates to a high-frequency snare 1 that excises a polyp with a high-frequency current, and its overall configuration is shown in FIG. 1A shows the distal end portion of the insertion portion (sheath) 2, and FIG. 2B shows the proximal portion of the insertion portion 2.

As shown in FIG. 2, the high-frequency snare 1 is provided with a sheath-shaped insertion portion 2 and an operation portion 3 connected thereto, so that the wire portion 4 is projected and retracted from the tip of the insertion portion 2. Is becoming The operation portion 3 is detachable from the insertion portion 2, and the wire portion 4 is also detachable from them.

As shown in FIG. 1, the insertion portion 2 of the high-frequency snare 1 is composed of a flexible inner sheath 5 made of a metal coil tightly wound and a flexible resin tube (outside) which is coated on the outer periphery thereof. Sheath 6). The tube 6 is formed over the entire length of the inner sheath 5 by closely adhering to and fixing the outer periphery of the inner sheath 5 by extruding, for example, a tetrafluoroethylene resin. As shown in FIG. 2A, the outer peripheral surface of the inner sheath 5 that covers the tube 6 has a corrugated concavo-convex shape due to the closely coiled coil wire 5a.
Since the tube 6 is formed by extruding resin on the outer peripheral surface of the inner sheath 5 as described above, the resin flows between the outer peripheral surface of the inner sheath 5 corresponding to the corrugated uneven outer peripheral surface, and the inner sheath 5 And the tube 6 are fixed in close contact with each other. As a result, not only the inner circumference of the tube 6 but also the outer circumference of the tube 6 has a corrugated shape that is substantially the same.

At the proximal end of the insertion portion 2, a connecting member 7 for detachably fixing the operation portion 3 is adhesively fixed.
The proximal end of the insertion portion 2 is inserted into a drill hole 8 coaxially formed at the tip of the connecting member 7 and fixed by adhesion.

The tip of the tube 6 projects about 1 mm from the tip of the inner sheath 5, and the inner and outer diameters of the projecting portion 9 are narrowed so as to be smaller than the base end side portion. Therefore, the insertion portion 2 does not catch when inserted into the forceps channel of the endoscope, and the tissue to be excised is less likely to contact the inner sheath 5. Of course, the protrusion 9 is formed at the same time when the tube 5 is formed by tubing by extrusion.

On the other hand, the wire portion 4 is a snare wire 10 formed by cutting a conductive wire in the middle to form a bent loop shape.
And an operating wire 11 connected to the snare wire 10. In addition, the operation unit 3 includes the operation unit main body 12
And a slider 1 that can move back and forth with respect to the operation section body 12.
3, the distal end of the operation portion main body 12 is detachably connected to the proximal end of the insertion portion 2, and the slider 13
Is detachably connected to the proximal end of the operation wire 11 via an operation pipe 14. Although not shown, the wire portion 4 is electrically connected to the high frequency power source via the slider 13 and a connection cord.

Next, the operation of the structure of the first embodiment will be described. First, after introducing the tip of the endoscope into the body cavity, the insertion section 2 of the high-frequency snare 1 is introduced through the forceps channel of the endoscope, and the tip of the insertion section 2 is introduced into the body cavity. During this work, the slider 13
Is pulled toward the hand side, so that the snare wire 10 is installed inside the insertion portion 2 as shown in FIG.

Then, under the observation of the endoscope, the endoscope is operated to guide the tip of the high-frequency snare 1 to the vicinity of the polyp. After that, when the slider 13 is pushed toward the tip side and the snare wire 10 of the wire portion 4 is pushed out from the tip of the insertion section 2, the snare wire 10 opens in a state of protruding from the tip of the insertion section 2 as shown in FIG.

Thereafter, the operation of the endoscope and the operation of advancing and retracting the high-frequency snare 1 are combined to hook the snare wire 10 on the polyp, and then the slider 13 is pulled toward the hand side.
The snare wire 10 is pulled into the insertion portion 2 and the polyp is tightly bound. Then, a high frequency power source (not shown) supplies a high frequency wave to the snare wire 10 to burn off the polyp.

In the structure of this embodiment, since the resin tube 6 is formed on the outer peripheral surface of the inner sheath 5 by extrusion molding to cover the inner sheath 5, the inner sheath 5 and the tube 6 are firmly adhered and fixed over the entire length of the inner sheath 5. Sheath 5 and tube 6
Do not shift from each other. That is, since the tip of the metal inner sheath 5 is not exposed from the tip of the tube 6, the tip of the metal inner sheath 5 is not exposed.
There is no possibility that normal tissue other than the target site will be cauterized by high frequency through the exposure from the tip to the outside.

Further, since the tube 6 is in close contact with the outer periphery of the inner sheath 5, the outer diameter of the insertion portion 2 composed of both of them is as small as possible, and the insertion portion 2 can be made thinner. Since the diameter of the insertion portion 2 is reduced in this manner, the amount of insertion / removal force when inserting / removing the insertion portion 2 into / from the forceps channel of the endoscope can be reduced. In addition, the outer tube 6
Since the outer peripheral surface of the forceps is corrugated, when the insertion portion 2 is inserted into the forceps channel, the contact area with the inner wall of the forceps channel is reduced, so that the sliding resistance is reduced and the amount of insertion / removal force is reduced. Will be reduced.

Further, in the construction of this embodiment, the inner sheath 5 and the tube 6 are in close contact with each other over the entire length of the insertion portion 2, so that even when the insertion portion 2 is curved, the inner sheath 5 It is possible to prevent the displacement between the coil wires of (1) by the tube 6 which is in close contact with the outside. As a result, it is possible to suppress an increase in the sliding resistance of the wire portion 4 with the operating wire 11 due to the displacement between the coil wires of the inner sheath 5. That is, the snare wire 10 can always be opened and closed with a stable and light force.

Since the narrowed portion of the protruding portion 9 of the tube 5 can be formed at the same time as the extrusion molding of the other portion of the tube 6, the protruding portion 9 can be produced at low cost and its strength can be secured.

FIG. 3 shows a second embodiment of the present invention. This embodiment relates to a grasping forceps, and the insertion portion 2 has an inner sheath 5 made of a metal coil and an outer circumference thereof, for example, tetrafluoroethylene, as in the case of the first embodiment. The tube 6 is formed by extruding and molding a resin so as to be closely fixed and covered.

On the other hand, the grasping forceps portion 15 composed of two grasping arms 15a and 15b made of a metal elastic body is connected and fixed by brazing or the like via the operation wire 16 and the connecting pipe 17 to form the wire portion 18. is doing. The wire portion 18 is inserted into the inner hole of the insertion portion 2 so as to be movable back and forth.

Further, a short cylindrical metal tip tip 19 is attached to the tip of the inner sheath 5, and the tip tip 19 is provided between the two grasping arms 15a and 15b of the grasping forceps portion 15. Entering and dividing it into two, a pin 20 is provided.

On the other hand, although not shown, the proximal end of the insertion portion 2 is fixed to the operation portion main body 12 having a cock capable of sending a liquid, and the proximal end of the wire portion 18 moves forward and backward with respect to the operation portion main body 12. It is adapted to be fixed to a free slider 13.

Next, the operation of the structure of this embodiment will be described. The tip portion of the grasping forceps is introduced into the body cavity through the channel of the endoscope introduced into the body cavity. On this occasion,
The slider 13 is pulled toward the hand side, and the two gripping arms 15a and 15b are pulled into the insertion portion 2 and are in a closed state. And under the observation of the endoscope,
The endoscope is operated to guide the tip of the grasping forceps portion 15 to the vicinity of the foreign matter in the body cavity. At that time, if the foreign matter is covered with blood, mucus, etc. and is difficult to confirm, physiological saline is injected through the cock of the operation section 3 to inject it from the tip opening of the insertion section 2 to wash the foreign matter. Then, after confirming the foreign matter, the slider 13 is pushed out to the distal end side, the forceps portion 15 is protruded more than the insertion portion 2 and opened, and then the insertion portion 2 is inserted.
The slider 13 toward the hand side while pressing the
The grasping arms 15a and 15b of the forceps portion 15 are closed to grasp the foreign matter. After that, it is removed from the body together with the endoscope to collect the foreign matter.

According to this embodiment, as in the first embodiment, the outer tube 6 is not displaced with respect to the inner sheath 5, so that the displacement of the outer tube 6 lowers the liquid-sending ability and the internal vision. It is possible to prevent a catch or the like when inserting the mirror. Further, the grasping forceps of this embodiment can also be used with a high-frequency treatment tool, and in that case, the same effect as that of the first embodiment can be obtained.

FIG. 4 shows a third embodiment of the present invention. This embodiment differs from the first embodiment described above in that the cross-sectional shape of the closely coiled metal coil wire 21a forming the inner sheath 21 is different. That is, the closely wound end faces of the coil wire 22 are flat and closely adhere to each other, and the inner side face 22a and the outer side face 22 thereof are
b is a concave shape that is depressed in an arc shape. The inner and outer peripheral surface portions of the inner sheath 21 are each formed in a wavy shape. The outer peripheral surface shape of the tube 23, which is formed on the outer peripheral surface of the inner sheath 21 by extrusion molding over its entire length, is formed in a corrugated shape along with the corrugated shape of the outer peripheral surface portion of the inner sheath 21. Other configurations are similar to those of the first embodiment.

In this embodiment, the cross-sectional shape of the coil wire 22 of the inner sheath 21 has a drum-like shape in which the center is dented on both the inner and outer surfaces. Furthermore, the shape of the outer peripheral surface of the tube 23 is also corrugated according to the shape of the outer peripheral surface of the inner sheath 21.

With such a structure, however, when inserted into the forceps channel of the endoscope, the contact area with the inner wall of the forceps channel is smaller than in the first embodiment, and the sliding resistance is smaller. The amount of insertion and removal becomes light. Further, even when the clearance between the coil wires 22 is small and the resin cannot be expected to flow in, the outer sheath adheres in a wavy shape along the drum-shaped coil cross section, so that the inner sheath 21 and the tube 23 outside the inner sheath 21. Displacement can be firmly prevented. Other effects are similar to those of the first embodiment.

The present invention is not limited to the above embodiments. For example, in each of the above-mentioned embodiments, the resin tube is extruded over the entire length of the inner sheath to form a coating, but this extruded portion is extruded only in the particularly required distal end side portion of the insertion portion. You may do it. Especially as the tip side part that is necessary depends on the usage and the like, but for example, when the necessary amount of the tip is projected from the tip of the forceps channel of the endoscope, from the tip to the part located in the curved part of the endoscope The range includes at least the part.

[0032]

As described above, according to the present invention, since the outer peripheral surface of the inner sheath is covered with the tube formed by extrusion molding, the inner sheath and the tube covering the outer peripheral surface thereof are firmly and firmly fixed to each other. Therefore, the inner sheath and the tube covering it are not displaced. Thereby, for example, the tip of the inner sheath is exposed from the tip of the tube, and there is no fear of burning normal tissue other than the target portion.

Further, since the outer tube is formed in close contact with the inner sheath by extrusion molding, the outer diameter of these sheaths is small and the diameter can be reduced, so that the amount of operation force to be inserted into the endoscope can be reduced. .. Furthermore, since the outer peripheral surface of the outer tube is usually wavy, the contact area with the inner wall of the forceps channel of the endoscope is small, and the sliding resistance can be further reduced. This also reduces the amount of insertion / removal force with respect to the endoscope.

When the inner sheath is bent, the displacement between the coil wires of the inner sheath can be prevented by the tube closely attached to the outer circumference thereof. As a result, it is possible to suppress an increase in sliding resistance with respect to, for example, the operation wire that is inserted into the inner sheath so as to be able to advance and retract due to the displacement between the coil wires of the inner sheath. Then, the treatment section such as the snare wire can always be operated with a stable light force.

[Brief description of drawings]

FIG. 1A is a cross-sectional view of a tip portion of a high-frequency snare insertion portion according to a first embodiment of the present invention, and FIG. 1B is a cross-section of a proximal end portion of the high-frequency snare insertion portion. Fig.

FIG. 2 is an external view showing the entire high frequency snare according to the first embodiment of the present invention.

FIG. 3 is a cross-sectional view of the distal end portion of the grasping forceps according to the second embodiment of the present invention.

FIG. 4 is a sectional view of a distal end portion of an insertion portion of a high-frequency snare according to a third embodiment of the present invention.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... High frequency snare, 2 ... Insertion part, 4 ... Wire part, 5 ... Inner sheath, 5a ... Coil element wire, 6 ... Tube, 10 ... Snare wire, 15 ... Grasping forceps part, 18 ... Wire part, 21 ...
Inner sheath, 22 ... Coil wire, 23 ... Tube.

Claims (1)

[Claims] 1. A flexible coil sheath made of a metal coil,
In a treatment tool for an endoscope having an insertion portion formed by covering a tube made of synthetic resin, the tube is closely fixed to the outer circumference of the sheath by extruding synthetic resin on the outer circumference of the sheath. A treatment tool for an endoscope characterized by the above.