JPH0723975A - High-frequency scalpel - Google Patents

Abstract

PURPOSE:To provide a high-frequency scalpel which forms a plurality of cutting portions by control of sliders provided in a control. CONSTITUTION:A high-frequency scalpel 1 comprises a sheath 2, a wire 3 for insertion into the sheath 2, and a control 4 provided with a first slider 41 to which the end of the conductive wire 3 is connected and a second slider 42. The wire 3 passed through the sheath 2 is exposed to the outside from holes 21, 22 bored at the end portion of the sheath 2, forming a cutting portion 31. The wire 3 is connected to the first slider 41 at one end portion 3a via a connecting tube 43 and to the second slider 42 at the other end portion 3b via a connecting rod 44; That is, the control 4 of the high-frequency scalpel 1 is provided with the first slider 41 that freely makes back and forth with respect to the front side of a control main body 45 connected to the end of the sheath 2 and the second slider 42 that freely makes back and forth with respect to the back side of the first slider 41.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a high-frequency incision instrument which is inserted endoscopically into a body cavity and incises, for example, the duodenal papilla.

[0002]

2. Description of the Related Art In recent years, various treatments have been performed by inserting a slender insertion portion into a body cavity and visually observing it or observing it with a monitor, and various treatment tools inserted in a treatment tool channel as necessary. Medical endoscopes capable of performing treatment are widely used.

For example, treatment instruments to be inserted into the duodenal papilla through an endoscope include a contrast tube, a balloon catheter, a high-frequency incision instrument and the like.

For example, Japanese Utility Model Publication No. 58-18887, Japanese Utility Model Publication No. 59-17290 and Japanese Utility Model Publication No. 60-3169.
No. 0, U.S. Pat. No. 4,485,812, etc., show a high-frequency incision instrument for incising an affected part in a body cavity by using a high-frequency current.

In these high-frequency dissection tools, a conductive wire is inserted into a flexible sheath having electrical insulation properties, and the tip of the conductive wire is exposed on the outer peripheral surface near the tip of the sheath. The end portion of the slider is fixed to a slider that can be moved back and forth provided on the operation portion.

In the high-frequency incision tool, a slider is towed to bend the tip of the sheath to form an incision, or a so-called pull type is used, or a wire is pushed out to sag the wire in a mountain shape to form the incision. There is a so-called push type that forms, or a so-called shark fin type that forms an incision in the shape of a shark's dorsal fin, and these types of incision tools are selectively used according to the operator's preference, and the incision is made. The affected part was incised by contacting the affected part with the affected part and passing a high-frequency current through the conductive wire.

[0007]

However, when using a high-frequency incision instrument having a plurality of incision shapes, the operator has a high-frequency wave having an incision in any one of these incision shapes. The incision tool was selected and used.

Therefore, when a situation occurs in which the treatment can be performed more efficiently by exchanging the high-frequency incision device having another incision shape during the treatment, the high-frequency incision device that has been used up to now can be used once. Since the high-frequency treatment instrument having a new desired incision shape must be inserted into the endoscope treatment instrument channel after being removed from the endoscope treatment instrument channel,
It was a troublesome task.

It is an object of the present invention to provide a high-frequency incision tool which forms a plurality of incision shapes by operating a slider provided on an operation section.

[0010]

In order to solve the above-mentioned problems, a high-frequency incision device of the present invention is provided with a flexible sheath having an electrically insulating property and a part of the flexible sheath which is inserted through the flexible sheath. Connects a conductive wire that is exposed on the outer peripheral surface near the distal end of the flexible sheath and forms an incision, and one end of the conductive wire that is provided so as to be able to move forward and backward to an operating portion arranged at the proximal end of the flexible sheath. And a second slider to which the other end of this conductive wire is connected.

[0011]

With this structure, of the first slider and the second slider provided on the operating portion, for example, the second slider is retracted and the conductive wire is pulled to thereby bend the flexible sheath and pull it. Forming an incision. In addition, the push-type incision is formed by advancing the second slider and pushing out the conductive wire. Further, the first slider is advanced to push out the conductive wire to form a dorsal fin-like incision portion of the shark.

[0012]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 5 relate to a first embodiment of the present invention, FIG. 1 is a sectional view showing a schematic configuration of a high-frequency incision tool, and FIG. 2 is a diagram showing a state in which an incision is not formed in the high-frequency treatment tool, FIG. Three
Is a drawing showing a pull type incision formed on the high-frequency treatment instrument, FIG. 4 is a drawing showing a dorsal fin-like incision formed on the high-frequency treatment instrument, and FIG. 5 is a diagram showing a push-type incision formed on the high-frequency treatment instrument. Is.

As shown in FIG. 1, a high-frequency incision tool 1 includes a flexible sheath 2 (hereinafter abbreviated as sheath 2) having an electrically insulating property, which serves as an insertion portion to be inserted into a body cavity. Conductive wire 3 to be inserted (hereinafter abbreviated as wire 3)
And a first slider 41 located on the sheath side of the operating portion 4 to which the end of the conductive wire 3 is connected, and a second slider 42 located on the proximal side.

The wire 3 inserted through the sheath 2 is
An incision portion 31 is formed by being exposed to the outside from through holes 21 and 22 formed at the distal end portion of the sheath 2 along the axial direction at a predetermined interval.

The end 3a of the wire 3 is connected to the first slider 41 of the operating portion 4 arranged at the base end of the sheath 2 via the connecting pipe 43, and the end 3b of the wire 3 is connected. The operation unit 4 arranged at the proximal end of the sheath 2 via the rod 44.
Of the first slider 41 or the second slider 42, and is connected to a high frequency power source (not shown).

That is, in the case of the present embodiment, the operating portion 4 of the high-frequency incision tool 1 is provided with the first slider 41 which is movable forward and backward on the front side of the operating portion main body 45 connected to the proximal end portion of the sheath 2. The second slider 42 which is movable behind and behind the first slider 41 with a space a taken into consideration in consideration of the moving distance of the wire 3.
Is provided.

The wire end 3a inserted through the through hole 21 formed at the distal end of the sheath is connected to the connecting pipe 43 fixed to the first slider 41, and the connecting rod 44 fixed to the second slider 42 is connected. The wire end 3b inserted through the through hole 22 formed at the distal end of the sheath is connected.

The operation of the high-frequency incision tool 1 constructed as described above will be described. First, when a procedure such as incision of the duodenal papilla is performed using the high frequency incision tool 1, the sheath 2 of the high frequency incision tool 1 is inserted endoscopically into the body cavity. Then, the distal end portion of the sheath 2 protruding from the distal end of the endoscope is inserted into the common bile duct, and the incision 31 is disposed near the papillary sphincter.
At this time, as shown in FIG. 2, the incision portion 3 of the high-frequency incision tool 1
In No. 1, since the operator has not moved the first slider 41 and the second slider 42 provided in the operation unit 4, the wire 3 arranged near the papillary sphincter is in a straight state.

Next, when the incision portion 31 of the high-frequency incision tool 1 is formed into a pull-type incision shape, the second slider 42 provided on the operation portion 4 is pulled toward the hand side to pull the wire 3. Then, as shown in FIG. 3, the distal end portion of the sheath 2 is curved so that the incision 31 has a pull-type incision shape.

When the incision portion of the high-frequency incision tool 1 has a push-type incision portion shape, the second slider 42 provided in the operating portion 4 is advanced to push the wire 3 out of the through hole 22, and thus the incision portion 31. Is a push type incision.

Further, when the incision shape of the high-frequency incision tool 1 is to be a shark's dorsal fin-like incision shape, the first slider 41 provided in the operating portion 4 is advanced to push out the wire 3 from the through hole 21 to make an incision. The portion 31 has a dorsal fin-like incision shape.

Then, a high-frequency current is passed through the wire 3 forming the incision 31 having the incision shape selected by the operator to incise the papillary sphincter.

As described above, by operating the first slider or the second slider provided on the operating portion of the high-frequency incision device, the operator inserts the sheath of the high-frequency incision device into the endoscope. An appropriate operation can be performed by shaping the incision shape of the incision provided on the distal end of the sheath into a desired shape.

Further, since the shape of the incision of the incision provided at the distal end of the sheath can be changed while the sheath of the high-frequency incision tool remains inserted in the endoscope, the shape of the incision can be changed as before. The time and effort for exchanging with a different high-frequency incision device can be saved, and surgery can be performed quickly.

The positional relationship between the first slider and the second slider arranged in the operating portion is not limited to the positional relationship of the embodiment, but the front-back relationship between the first slider and the second slider is reversed. May be in a positional relationship of. Further, the relationship between each slider and the wire end portion connected thereto is not limited to the connection relationship of the embodiment.

FIG. 6 is a sectional view showing the schematic arrangement of a high-frequency incision tool according to the second embodiment of the present invention. As shown in the figure, the high frequency incision instrument 10 of the present embodiment forms a first lumen 11 and a second lumen 12 in a flexible sheath, and the first lumen 11 and the second lumen 12 are formed. The cavity 12 is communicated with the through hole 13,
The wire 3 is inserted through the first lumen 11 and the second lumen 12. The wire 3 that is inserted through the first lumen 11 is connected to the first slider 41a that is provided on the lower side of the operation portion 4 and that can move back and forth, and the wire 3 that is inserted through the second lumen 12 is inserted.
Is a second slider 4 provided on the upper side of the operation portion 4 and capable of moving back and forth.
2a. Unlike the first embodiment, the first slider 41a and the second slider 42a are provided with only one finger hole to be inserted when operating each slider. Other configurations are the same as those of the above-described embodiment, the same members are designated by the same reference numerals, and description thereof will be omitted.

As described above, the high-frequency treatment instrument of this embodiment is
Since the first slider and the second slider are arranged vertically in the operation portion instead of being arranged front and rear, the movement distance of the slider can be made sufficiently long, so that the operability is improved.

[0028]

According to the present invention, it is possible to provide a high-frequency incision tool which forms a plurality of incision shapes by operating a slider provided on an operating portion.

[Brief description of drawings]

1 to 5 relate to a first embodiment of the present invention,
FIG. 1 is a sectional view showing a schematic configuration of a high-frequency incision tool.

FIG. 2 is a view showing a state in which an incision is not formed in the high-frequency treatment instrument.

FIG. 3 is a diagram in which a pull type incision is formed in the high frequency treatment device.

FIG. 4 is a diagram showing a high-frequency treatment instrument with a dorsal fin-like incision formed therein.

FIG. 5 is a diagram showing a push type incision formed on the high-frequency treatment instrument.

FIG. 6 is a sectional view showing a schematic configuration of a high-frequency incision tool according to a second embodiment of the present invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... High frequency incision tool 2 ... Flexible sheath (sheath) 3 ... Conductive wire (wire) 4 ... Operation part 31 ... Incision part 41 ... 1st slider 42 ... 2nd slider

Claims (1)

[Claims] 1. A flexible sheath having an electrical insulation property, and a conductive wire which is inserted through the flexible sheath and partially exposed at an outer peripheral surface near the distal end of the flexible sheath to form an incision. A first slider to which one end of the conductive wire, which is provided so as to be able to move forward and backward, is connected to an operating portion arranged at the proximal end of the flexible sheath, and a second slider to which the other end of the conductive wire is connected A high-frequency incision tool comprising: