JPH055106U - High frequency treatment tool for endoscope - Google Patents

Abstract

(57) [Summary] [Purpose] An object of the present invention is to provide a high-frequency treatment instrument for an endoscope, which can prevent burns and the like due to poor contact, perform efficient treatment, and reliably grip an affected area. A flexible tube (2) having electrical insulation to be inserted into a treatment instrument insertion channel of an endoscope, and a pair of pivotally attached to the tip of the flexible tube (2) electrically insulated from each other and openable and closable. Of the processing electrodes 4a and 4b and the electrodes 4a and 4b, respectively, for opening and closing the electrodes,
Extending in the flexible tube 2 electrically insulated from each other,
A plurality of conducting and actuating cables 16a and 16b, which are partially fixed to each other, and an operating unit 30 including connecting means for individually connecting the ends of the cables 16a and 16b to a high frequency power source. The electrodes 4a and 4b are protruded inward, and when the electrodes 4a and 4b are closed, each electrode 4
At least one insulating stopper 20 is provided to prevent the tips of a and 4b from coming into contact with each other.

Description

[Detailed description of the device]

[0001]

[Industrial applications]

 The present invention relates to a high-frequency treatment instrument for an endoscope, which is endoscopically introduced into a body cavity and performs processing such as incision, excision or coagulation of tissue in the body cavity.

[0002]

[Prior Art]

 Conventionally, as a high-frequency treatment instrument used endoscopically, as shown in JP-A-58-152914, only one treatment-side electrode is introduced into a body cavity and the other electrode (counter electrode plate) is used. ) Widely contacts the skin of the affected area, and concentrates a high-frequency current at the contact area of the treatment-side electrode introduced into the body cavity with the affected area to dissect, ablate or coagulate the tissue at the contact area. Those who carry out treatment are known.

Further, as disclosed in Japanese Utility Model Publication No. 53-34232 and US Pat. No. 4,0057,414, a part that does not come into contact with the affected tissue is covered with an insulating material so that the parts are insulated from each other and elastically expanded. A high-frequency treatment tool for opening and closing the bipolar treatment electrodes, which have been imparted with properties, is opened and closed by projecting and retracting the bipolar treatment electrodes from the distal end of the sheath, thereby gripping the affected area and performing the various treatments described above. Proposed.

On the contrary, the one disclosed in German Patent Laid-Open Publication No. DE 27334847 discloses that the sheath is a bipolar electrode for treatment which is elastically expanded and accommodated in the sheath. By moving the electrodes for treatment with two poles from the sheath tip, the electrodes for treatment are made to open and close by gripping the affected area, and a treatment similar to that in each of the above publications is performed.

[0005]

[Problems to be solved by the device]

 However, in JP-A-58-152914, only one electrode on the treatment side is introduced into the body cavity, and the other electrode (counter electrode) is brought into contact with the skin of the affected area for treatment, so that the efficiency and efficiency are improved. There is a possibility that it may be inconvenient in terms of processing capacity, or that the skin may be burned due to poor contact with the counter electrode.

On the other hand, in Japanese Utility Model Publication No. 53-342232 and US Pat. No. 4,0057,14, since there is no counter electrode arranged on the skin of the affected area, the skin burn due to poor contact can be avoided, but elastic expansion is performed. In some cases, the affected part cannot be reliably gripped because the bipolar electrode for treatment, which is imparted with the property, moves back and forth from the sheath. Further, since the insulating coating portion of each electrode slides, there is a risk that the coating portion may slacken to cause malfunction.

On the other hand, in the one disclosed in German Patent Laid-Open Publication No. DE 27334847, the electrode is apt to bend due to the movement of the sheath, so that the affected area cannot be reliably grasped.

The present invention has been made in view of the above circumstances, and an object of the present invention is to prevent burns and the like due to poor contact, perform efficient treatment, and reliably grip an affected area. An object is to provide a high-frequency treatment instrument for an endoscope.

[0009]

[Means for Solving the Problems]

 In order to solve the above-mentioned problems, a high-frequency treatment instrument for an endoscope of the present invention includes a flexible tube having electrical insulation to be inserted into a treatment instrument insertion channel of an endoscope, and a tip of the flexible tube. And a pair of processing electrodes that are electrically insulated from each other and pivotally attached so as to be openable and closable, and are connected to each electrode to open and close the electrodes, and extend electrically insulated from each other in the flexible tube. A plurality of conducting and actuating cables that are partially fixed to each other, and an operating unit that includes connecting means for individually connecting the ends of each cable to the high-frequency power source. At least one insulating stopper is provided, which protrudes to the end and prevents the tips of the electrodes from coming into contact with each other when the electrodes are closed.

[0010]

A high-frequency current is supplied to the processing electrodes by connecting means for individually connecting the ends of the conductive actuating cables connected to the processing electrodes to the high-frequency power source. It flows locally. Further, since the processing electrode is pivotally attached to the tip of the flexible tube so as to be openable and closable, and the operation cable is partially fixed to each other, the operation force when opening and closing the processing electrode is It is possible to uniformly transmit to each operation cable, and it is possible to surely perform the opening / closing operation of the processing electrode to reliably grasp the affected tissue. The gripping force is regulated by an insulating stopper.

[0011]

【Example】

 Embodiments of the present invention will be described below with reference to the drawings. 1 and 2 show a first embodiment of the present invention. FIG. 1A shows a main part configuration of a high frequency treatment instrument for an endoscope 1 of the present embodiment. Reference numeral 2 denotes a flexible metallic member which is inserted into a treatment instrument insertion channel of the endoscope. And a forceps body 4 to be described later, which constitutes an insertion portion 6 of the high-frequency treatment instrument for endoscope 1. A substantially tubular insulative tip cover member 8 is fixed to the tip of the sheath 2. On the outer peripheral surface of the distal end portion of the sheath 2, there is formed a fixing groove portion 2a into which a fixing portion 8a formed on the proximal end portion side of the distal end cover member 8 is fitted.

A large diameter portion 8b having a diameter larger than that of the fixed portion 8a is formed on the tip end side of the tip cover member 8. A slit portion 8c is formed in the large diameter portion 8b of the tip cover member 8. The insulating tube 10 is covered from the fixed portion 8a of the tip cover member 8 to the outer circumference of the coil sheath 2.

Further, on the opening end side of the slit portion 8c of the tip cover member 8, a pair of forceps bodies 4a and 4b as processing electrodes are rotatably connected around a turning pin 12 so that the tip end is formed. It can be opened and closed. These forceps bodies 4a and 4b are provided with gripping portions 4c and 4d for gripping foreign matters in the body cavity on the tip end side and fixing portions 4e and 4f fixed to the rotating pin 12 on the base end side. ing. Each forceps body 4a, 4b is formed by twisting a part of a plate material such as a metal plate to form gripping parts 4c, 4d and fixing parts 4e, 4f.

Further, in the slit portion 8c of the tip cover member 8, as shown in FIG. 1B, an electrically insulating spacing member 14 is mounted around the rotating pin 12. Further, forceps body connecting grooves 14a and 14b are formed at both ends of the spacing member 14. Then, between the forceps body connecting grooves 14a, 14b of the spacing member 14 and the inner wall surface of the slit portion 8c of the tip cover member 8, the fixing portions 4e, 4f of the forceps bodies 4a, 4b are rotatable. The forceps bodies 4a and 4b are pivotally supported by each other and are insulated from each other. In addition, the gripping portions 4c and 4d of the forceps bodies 4a and 4b are protruded inward, respectively, and contact each other when the gripping portions 4c and 4d are in a closed state to prevent contact between tips of the gripping portions 4c and 4d. Stoppers 20, 20 are provided.

Further, two operation wires 16a and 16b as actuating cables are inserted into the sheath 2 and fixed to the fixing portions 4e and 4f of the forceps bodies 4a and 4b, respectively, as shown in FIG. 1 (c). Are connected to form a ring. One of the operation wires 16a is covered with an insulating tube 17, and the other end 16b is bound by a focusing member 18 on the distal end side.

The insertion section 6 is connected to the operation section 30 shown in FIG. 2 by a connection section 22 connected to the proximal side of the insertion section 6. In this case, the proximal end portion of the sheath 2 of the insertion portion 6 is connected to the sheath connecting portion 26 provided at the tip of the connecting member 24 of the connecting portion 22.

A third constricted groove 24 a is formed on the rear outer peripheral portion of the sheath connecting portion 26 of the connecting member 24. Further, the operating wire 16b, which is not covered with the insulating tube 17, is mechanically and electrically connected to the tubular member 28. The tubular member 28 has a part on the front end side thereof disposed substantially coaxially inside the connecting member 24, and the base end side projects from the base end of the connecting member 24. The operation wire 16 a covered with the insulating tube 17 extends through the tubular member 28, projects from the proximal end of the tubular member 28, and is fixed to the fixing portion 32 b formed on the distal end side of the first terminal 32. It is mechanically and electrically coupled. A first necked groove 32 a is formed on the outer periphery of the first terminal 32 on the base end side. In addition, the proximal end side of the tubular member 28 serves as a second terminal 29, and a second constricted groove 29a is also formed on the outer periphery of the second terminal 29.

The operation section 30 includes a main body 36 having a rail 35, a sheath fixing section 38 provided at the tip of the main body 36, and a slider 40 slidably provided along the axial direction of the main body 36. Consists of.

The sheath connecting portion 26 of the connecting member 24 can be detachably connected to the sheath fixing portion 38. That is, as shown in FIG. 3, the sheath fixing portion 38 comprises a rotating ring 38a and a fixing plate 38b, and an eccentric hole is provided in the rotating ring 38a. The fixing plate 38b is incorporated in this hole, and the eccentric hole is inevitably rotated by rotating the rotary ring 38a in a certain direction, whereby the fixing plate 38b incorporated in the eccentric hole is raised. The third constricted groove 24a of the connection member 24 is adapted to be engaged in the small hole 37 provided in the fixed plate 38b by sliding in the direction. To release this engagement, the rotary ring 38a may be rotated in the direction opposite to the above direction.

The main body 36 of the operating section 30 has a slit 39 in the center and a thumb rest 41 at the end. Further, the slider 40 has two finger rests 42 and 43, and also has two mounting portions, that is, a first mounting portion 45 and a second mounting portion 46, which are spaced apart in the axial direction. The first and second mounting portions 45 and 46 constitute connecting means for individually connecting the ends of the operation wires 16a and 16b to the high frequency power source.

As shown in FIGS. 4A and 4B, the first and second attachment portions 45 and 46 are respectively fixed to the slider 40 and have a substantially tubular shape that can slide in the slit 39. It has one containing member 51a and a second containing member 51b.

The first accommodating member 51 a and the second accommodating member 51 b are fixed to the slider 40 by engaging the flange portions 52 formed at both ends with the groove portions 40 b formed on the outer peripheral surface of the slider 40. It is held together with the slit 39.

First and second plugs 53 a and 53 b, which are electrically connected to a high-frequency power source, are formed at one ends of the first and second accommodating members 51 a and 51 b so as to extend from the flange portion 52. Has been done. Inside the first and second accommodating members 51a and 51b, the first and second push rods 55a and 55b and the first biasing rods 55a and 55b in the axial direction of the accommodating members 51a and 51b. And the second springs 57a, 57b are accommodated. The first and second push rods 55a and 55b are constricted portions 59 having thin ends formed on the opposite side to the side biased by the springs 57a and 57b. It projects outward from an opening 60 provided at the other end of the first and second accommodating portions 51a and 51b, and the projecting end is formed in a large-diameter button portion 61. In the normal state of the push rods 55a and 55b, a stepped portion 63 that forms the constricted portion 59 is formed at the end of the inner peripheral surface of the accommodating members 51a and 51b by the biasing force of the springs 57a and 57b. It is held in the accommodating members 51a and 51b while hitting the stepped portion 65. A through hole 67 and a groove 69 reaching the through hole 67 are formed in each of the first and second push rods 55a and 55b.

When connecting the insertion portion 6 to the operation portion 30, first, the base end side portion of the connection portion 22 is passed through the slit 39 of the main body 36 of the operation portion 30. Then, by pushing the button portion 61 of the first and second mounting portions 45 and 46, the first and second push rods 55a and 55b are opposed to the urging force of the first and second springs 57a and 57b. Then, the first terminal 32 and the second terminal 29 of the connecting portion 22 are inserted into the through holes 67 of the first and second push rods 55a and 55b. Then, after positioning the first constricted groove 32a of the first terminal 32 and the second constricted groove 29a of the second terminal 29 near the groove 69 of the first and second push rods 55a, 55b, Release the button portion 61. As a result, the first and second push rods 55a and 55b are pushed up by the urging force of the first and second springs 57a and 57b, and the first and second push rods 55a and 55b are inserted into the grooves 69 of the first and second push rods 55a and 55b. The first constricted groove 32a of the terminal 32 and the second constricted groove 29a of the second terminal 29 are fitted to each other, and the operation wires 16a and 16b are fixed to the slider 40.

Further, the vicinity of the sheath connecting portion 26 of the connecting member 24 is positioned inside the sheath fixing portion 38 of the operation portion 30, and the rotating ring 38a of the sheath fixing portion 38 is rotated to slide the fixing plate 38b to slide the fixing plate. 38b engages the third constricted groove 24a of the connecting member 24. As a result, the sheath 2 is connected to the connecting portion 22 and also connected to the operating portion 30.

Next, the operation of the endoscope high-frequency treatment tool 1 having the above-described configuration will be described. First, when the high frequency treatment instrument for endoscope 1 is used, the high frequency treatment instrument for endoscope 1 is introduced into the body cavity through the insertion channel of the endoscope. Then, the endoscope high-frequency treatment instrument 1 is operated after bringing the distal end portion of the endoscopic high-frequency treatment instrument 1 close to a foreign object to be collected under observation with the endoscope.

When operating the high-frequency treatment instrument 1 for an endoscope, the slider 40 of the operating portion is operated. In this case, for example, by pushing out the slider 40 of the operating section 30 toward the distal end side, the operating wires 16a and 16b are pushed together to open the gripping portions 4c and 4d of the forceps bodies 4a and 4b at the distal end, The open forceps bodies 4a and 4b are guided to a tissue in a body cavity, for example, a bleeding site.

In this state, subsequently, by pulling the slider 40 of the operating portion 30 toward the operator's side to pull the operating wires 16a, 16b toward the operator's side, the grasping portion 4c of the forceps 4a, 4b at the tip is grasped. , 4d are closed and the foreign matter is gripped. At this time, the tips of the gripping portions 4c and 4d do not come into contact with each other due to the contact between the opposing stoppers 20 and 20 provided on the gripping portions 4c and 4d.

Then, a high-frequency power source (not shown) and the plugs 53a, 53b of the housing members 51a, 51b provided on the first mounting portion 45 and the second mounting portion 46 in the slider 40 of the operation unit 30 are electrically connected. Connection, and a high-frequency current is individually applied to the operation wires 16a, 16b through the first attachment portion 45 and the second attachment portion 46 to energize the forceps bodies 4a, 4b. Since a high-frequency current flows between 4d, the grasped tissue can be cauterized and solidified.

Therefore, in the high-frequency treatment instrument for endoscope 1 having the above-described configuration, the ends of the operation wires 16a and 16b are individually connected via the two attachment parts 45 and 46 provided on the slider 40 of the operation part 30. The connection means for conducting to the high frequency power source is configured, and by this, the high frequency current is individually supplied to the forceps bodies 4a and 4b as the processing electrodes, so that the local processing capability can be enhanced. .. Moreover, since the body electrode plate is not used, the skin is not burned due to poor contact.

Further, the forceps bodies 4a and 4b are pivotally attached to the tip cover 8, and are rotated and opened and closed with the pivot pin 12 as an axis, and the operation wires 16a and 16b are bound together by a focusing member 18. Since it is securely fixed to one slider 40, when the forceps bodies 4a and 4b are opened and closed, the force can be evenly transmitted to the operation wires 16a and 16b, and the opening and closing operations of the gripping portions 4c and 4d. And the affected tissue can be reliably grasped.

On the other hand, the gripping portions 4c and 4d of the forceps bodies 4a and 4b are provided with insulating stoppers 20 and 20 projecting inside thereof, and contact each other when the gripping portions 4c and 4d are closed. Since the tips of the grips 4c and 4d are prevented from coming into contact with each other, the affected tissue is not gripped too much and is not mechanically cut. The connecting means for individually connecting the ends of the operation wires 16a and 16b to the high frequency power source is not limited to the one having the above configuration.

In addition, as shown in FIG. 5, the insulating stopper that prevents the tips of the gripping portions 4c and 4d from coming into contact with each other when the gripping portions 4c and 4d of the forceps bodies 4a and 4b are in the closed state is, as shown in FIG. There may be provided a member 70 which is provided only on 4a and comes into contact with the inner surface of the other gripping portion 4b when the gripping portions 4c and 4d are closed. Alternatively, as shown in FIG. 6, they are provided on the inner surfaces of the gripping portions 4c and 4d so as to contact the inner surfaces of the opposing gripping portions 4c and 4d without abutting each other. May be.

[0034]

[Effect of the device]

 As described above, according to the present invention, a high-frequency current is supplied to the processing electrodes by connecting means for electrically connecting the ends of the conductive working cables connected to the respective processing electrodes to the high-frequency power source. Since a high-frequency current is locally passed between the electrodes, its processing ability can be enhanced. Moreover, since the body electrode plate is not used, the body skin will not be burned due to poor contact or the like.

Further, since the processing electrode is pivotally attached to the distal end of the flexible tube so as to be openable and closable, and the respective operation cables are partially fixed together, it is possible to open and close the processing electrode. As a result, the operating force can be evenly transmitted to each operating cable, and the opening / closing operation of the processing electrode can be reliably performed to reliably grasp the affected tissue. On the other hand, the processing electrode has an insulating stopper that protrudes inward and prevents the tips of the electrodes from touching each other when the electrodes are closed. There is no mechanical disconnection.

[Brief description of drawings]

FIG. 1 (a) is a side sectional view of an insertion portion and a connection portion of a high-frequency treatment instrument for an endoscope showing a first embodiment of the present invention,
(B) is a longitudinal sectional view taken along line AA of (a), and (c) is a sectional view taken along line BB of (b).

FIG. 2 is a schematic configuration diagram of an operating portion of a high-frequency treatment instrument for an endoscope showing a first embodiment of the present invention.

FIG. 3 is a detailed cross-sectional view in which the connection portion of FIG. 1 is connected to the operation portion of FIG.

4A is a sectional view taken along the line CC of FIG. 3, FIG.
FIG. 4 is a sectional view taken along the line D-D in FIG. 3.

FIG. 5 is a cross-sectional view showing a modified example of the insulating stopper of the high-frequency treatment instrument for endoscope of FIG.

FIG. 6 is a cross-sectional view showing a modified example of the insulating stopper of the high-frequency treatment instrument for endoscope of FIG.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... High frequency treatment tool for endoscopes 2 ... Sheath 4 ... Forceps body 12 ... Rotating pin 16 ... Operation wire 18 ... Converging member 20, 70, 75 ... Insulation stopper 29, 32 ... 2nd terminal 30 ... Operation part 45 , 46 ... Mounting part

 ─────────────────────────────────────────────────── ─── Continuation of front page (72) Koichi Kawashima 2-43-2 Hatagaya, Shibuya-ku, Tokyo Within Olympus Optical Co., Ltd. (72) Kenichiro Maki 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Creator Masaaki Hayashi 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Hironobu Kono 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Industry Co., Ltd.

Claims (1)

Claims for utility model registration: 1. A flexible tube having electrical insulation to be inserted into a treatment instrument insertion channel of an endoscope, and a tip of this flexible tube electrically insulated from each other. A pair of openable and closable processing electrodes and opening and closing operations of these electrodes respectively connected to the respective electrodes and extending in the flexible tube electrically insulated from each other and partially fixed to each other. A plurality of conducting and actuating cables, and an operating section including connecting means for individually connecting the ends of each cable to a high-frequency power source, the processing electrode protruding inside thereof, and when the electrodes are closed. A high-frequency treatment instrument for an endoscope, comprising at least one insulating stopper that prevents the tips of the electrodes from coming into contact with each other.