JPH061128Y2 - High frequency incision tool - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial field of application] The present invention relates to a high-frequency incision instrument, more specifically, a high-frequency incision that is introduced endoscopically into a body cavity and incises tissue under observation with an endoscope. The present invention relates to a high frequency incision tool.

[Prior Art] Conventionally, a high-frequency incision device that is used by being inserted into a treatment instrument insertion channel of an endoscope is provided on one side surface near a distal end portion of a flexible sheath that is inserted into the treatment instrument insertion channel. Two through holes are provided back and forth in the axial direction, the tip of the conductive wire for high-frequency incision is fixed to the inner surface of the tip portion inside the flexible sheath, and the conductive wire is passed through the through hole near the tip, While leading out to the outside of the flexible sheath to form an incision, the conductive wire is introduced again into the flexible sheath through the through hole near the base, and the proximal end is moved forward and backward to the operating portion at hand. It is freely inserted.

Then, with the high-frequency incision device configured in this manner, for example, when incising the duodenal papilla, etc., insert the incision instrument into the body with a transoscope, and insert the distal end portion thereof into the bile duct from the duodenal papilla. To do. Then, by pulling the conductive wire with the hand operation portion, the incision portion of the conductive wire is stretched in a chordal shape of a bow, and the distal end portion of the flexible sheath is formed so as to form a wire knife. Make it bend. Then, a high-frequency current was passed through the conductive wire to perform an incision operation on the duodenal papilla sphincter.

By the way, in the conventional high-frequency incision instrument configured as described above, for example, as shown in FIG. 7, when the sphincter muscle of the duodenal papilla 17 is incised, the flexibility protruding from the distal end portion of the endoscope 14 is increased. It is not easy to insert the tip of the sheath 15 into the bile duct 18 from the duodenal papilla, and therefore, in this case, the guide wire 16 in the flexible sheath 15 is inserted, and the wire 16 is first inserted into the bile duct 18. After the insertion, the guide wire 16 is used as a guide, and the distal end of the flexible sheath 15 is guided to the bile duct 18 to be inserted.

[Problems to be Solved by the Invention] However, since the guide wire is also formed of a coil-shaped elastic elastic member in order to provide flexibility, it sometimes becomes difficult to insert the guide wire. Therefore, the actual application Sho6
No. 2-170996, a contrast tube 19 having a metal tip at its tip (see FIG. 8) is first inserted into the bile duct by a transoscope, and the guide wire 16 (the eighth tube) is inserted into the contrast tube 19. (See the drawing), and after inserting the guide wire 16 into the bile duct 18 (see FIG. 8), the contrast tube is removed, and then the flexible sheath 15 is guided into the bile duct 18 using the guide wire 16 as a guide. An inserting operation like inserting was performed. However, this operation has the drawback that it is very troublesome and complicated, and it is extremely troublesome and time-consuming. As disclosed in Japanese Utility Model Laid-Open No. 62-122609, a flexible sheath in which a pipe is fitted in the vicinity of the tip is also proposed. However, since the tip side ahead of the pipe is soft, insertability is improved. There is a problem that is bad. Furthermore, in the high-frequency incision tool disclosed in Japanese Utility Model Publication No. 58-18887, the identification substance is attached to the tip, but the substance is thick, so there is a problem in that the insertability is extremely poor. In addition, the Liberation 87098
In the high-frequency incision tool disclosed in Japanese Patent No. 23, the incision is formed by extending the thin plate to the vicinity of the tip, but this is easily bent in the curved direction of the plate, and therefore the insertability is even worse.

Therefore, in view of the above-mentioned problems in the conventional high-frequency incision instrument, an object of the present invention is to allow the distal end of the flexible sheath to be easily inserted even when it is inserted from the duodenal papilla into the bile duct. There is a high-frequency incision tool provided.

[Means and Actions for Solving the Problems] In order to achieve the above object, the present invention exposes a wire knife for high-frequency incision on a part of the outer surface of the distal end portion of an electrically insulating flexible sheath. A high-frequency incision tool, also called a papillotomy knife, made of a hard material having a guide portion having an outer diameter smaller than the outer diameter of the flexible sheath at the distal end of the flexible sheath. It is characterized in that a member is provided.

[Embodiment] Hereinafter, the present invention will be described based on an illustrated embodiment.

FIG. 1 is a cross-sectional view showing a main part of a high-frequency incision tool showing a first embodiment of the present invention, and FIG. 2 is a schematic view showing an overall configuration of the high-frequency incision tool. In FIG. 1, a pair of through holes 2 and 3 which are spaced apart in the front-rear direction are formed on one side surface of a distal end portion of a flexible sheath 1 made of a tube such as a synthetic resin material. Through the through holes 2 and 3, the electrically cutting conductive wire 4 having a tip fixed to a fixing pipe 6 fitted in the tip portion of the flexible sheath 1 is inserted. That is, the wire 4 is once led out from the through hole 2 of the flexible sheath 1 and then introduced into the flexible sheath 1 through the through hole 3 near the rear end so that the wire 4 can move back and forth. The portion that is drawn into the sheath 1 and exposed to the outside forms the incision 5.

Then, a metallic tip 7 is fitted and fixed to the tip of the flexible sheath 1. The tip side of the tip 7 is formed as an insertion guide portion 8 having a diameter smaller than the outer diameter of the flexible sheath 1, and a through hole 7a communicating with the inside of the sheath 1 is formed in the central axis portion of the tip 7. ing. Further, as shown in FIG. 2, a liquid feeding means comprising a liquid feeding member 9 having a liquid feeding port is connected to the rear end of the flexible sheath 1, and the liquid feeding member 9 is operated. The parts 10 are connected by a rotary ring 11. The operation section 10 is composed of an operation section body 12 and a slider 13, and the rear end of the conductive wire 4 is
The slider 13 is slidably disposed on the operation portion main body 12 via the liquid feeding member 9 and the rotary ring 11. The slider 13 is provided with a connection plug (not shown), and the conductive wire 4 is connected to a high frequency generator (not shown) via the plug and a cord. .

The high-frequency incision tool of the present embodiment configured in this way operates as follows. As shown in FIG. 3, when the flexible sheath 1 is inserted into the bile duct 18 from the duodenal papilla 17 through the treatment instrument insertion channel of the endoscope 14, the flexible sheath 1 A metallic tip 7 is fitted to the tip, and the tip serves as an insertion guide portion 8 that is much thinner than the outer diameter of the flexible sheath 1. Therefore, it is possible to insert the tip very easily. .

Next, the slider 13 of the operation portion main body 12 (see FIG. 2)
Is operated to pull the conductive wire 4 toward the proximal side, the incision portion 5 is formed into a chord shape of a bow as shown in the drawing to form a wire knife, and then the conductive wire 4 is moved from the high frequency generator (not shown) to the slider 13 mentioned above. By passing a high-frequency current through the plug, the sphincter muscle of the duodenal papilla 17 can be subjected to high-frequency incision.

As described above, in this embodiment, since the metallic thin pipe-shaped insertion guide 8 is provided at the distal end of the flexible sheath 1, it can be easily inserted into the bile duct or the like, and the sphincter muscle of the duodenal papilla or the like. Can be easily incised, and the drawbacks of the conventional high-frequency incision instrument of this kind can be satisfactorily resolved.

FIG. 4 is a side view of the distal end portion of the high-frequency incision tool showing the second embodiment of the present invention. The high-frequency incision tool of this embodiment is different from the high-frequency incision tool of FIG. 1 in the insertion guide portion 8.
The only difference is the shape. That is, the insertion guide portion 8A in this embodiment is composed of the guide head 21 and the guide body 22, the outer diameter of the guide head 21 is slightly larger than the diameter of the guide body 22, and the distal end peripheral surface is smooth. Is chamfered.

In the high-frequency incision tool of the present embodiment configured as described above, since the distal end surface of the insertion guide portion 8A is chamfered, the duodenal papilla portion 1 when inserted into the bile duct 18 (see FIG. 3).
There is no additional damage to 7 and the effect of smooth insertion is further added.

5 and 6 are side views showing other examples of the insertion guide portions 8 and 8A shown in FIGS. 1 and 4, respectively. The insertion guide portion 8B shown in FIG.
6 has a spherical shape, and in the insertion guide portion 8C shown in FIG. 6, the guide head 21C has a cannonball shape, and the outer diameter of each is larger than the outer diameter of the guide bodies 22B and 22C. Is smaller than the outer diameter of. By constructing the insertion guide portions 8B and 8C in this manner, the insertability is further improved, and other operational effects are exactly the same.

In addition, although the insertion guide members in each of the above-described embodiments are formed of a metal material, this is not limited to a metal material, and it is a matter of course that a hard non-conductive material such as a ceramic material may be used. , There is no change in its action and effect.

[Effects of the Invention] As described above, according to the present invention, a hard tip having a small-diameter insertion guide portion is provided at the distal end of the flexible sheath. Therefore, for example, it is inserted from the duodenal papilla into the bile duct. Even in such a case, it is possible to provide a high-frequency incision device which can be inserted very easily and which has excellently solved the drawbacks of the conventional high-frequency incision device of this kind.

[Brief description of drawings]

FIG. 1 is a cross-sectional view of a main part of a high-frequency incision tool showing a first embodiment of the present invention, FIG. 2 is a schematic diagram showing the overall configuration of the high-frequency incision tool of FIG. 1, and FIG. FIG. 4 is a side view of a main part of the high-frequency incision tool shown in FIGS. 1 and 2, showing a mode of use of the high-frequency incision tool. FIG. FIG. 6 is a side view showing another example of the insertion guide part in FIG. 1, and FIGS. 7 and 8 are side views of the essential parts showing the conventional usage of the high-frequency incision tool. 1 ………… Flexible sheath 7 ………… Chip (insertion guide member) 8 ………… Insert guide part

Claims (1)

[Scope of utility model registration request] 1. A high-frequency incision tool comprising a wire knife for high-frequency incision exposed on a part of an outer surface of a distal end of an electrically insulating flexible sheath. A high-frequency incision tool, characterized in that an insertion guide member made of a hard material having a guide portion having an outer diameter smaller than the diameter is provided at the tip of the flexible sheath.