JPH079302U - Endoscopic treatment tool - Google Patents

Abstract

(57) [Abstract] [Purpose] Improve durability against repeated bending force at the proximal side of the insertion part. [Configuration] Synthetic resin is extruded on the outer periphery of the metal coil sheath 5. And an engagement member 22a coaxially fixed to the base end of the insertion portion.
And a protective member 24 laminated and fixed to the engaging member,
Inside the protection member 24, the engagement member 22 a
And a heat-shrinkable tube 23 made of synthetic resin on the outer periphery of the insertion end base end.
Was at least double coated.

Description

[Detailed description of the device]

[0001]

[Industrial applications]

 TECHNICAL FIELD The present application relates to an endoscopic treatment tool, particularly an endoscopic treatment tool such as a high-frequency snare or a grasping forceps that is used endoscopically.

[0002]

[Prior art]

 Generally, when a grasping forceps or a high-frequency snare is used transendoscopically to grasp or excise a large foreign object or a large site in a body cavity, a force for bending the insertion portion is applied to the insertion portion.

Even when a force for bending the insertion portion is applied, the bending prevention tube is covered and fixed to the proximal end portion of the insertion portion on the proximal side, so that the bending force is reduced to some extent. Further, as shown in Japanese Utility Model Laid-Open No. 158914/1983, a Teflon tube which is double reinforced is also proposed.

[0004]

[Problems to be solved by the device]

 However, when the insertion portion is subjected to an excessive force and is in a curved state, the largest force is applied to the portion where the flexibility changes rapidly, that is, the boundary between the insertion portion and the operation portion. When the bending operation is repeatedly performed at that portion, the coil sheath inside the insertion portion is often cut first, and then the covering tube is often cut.

Even if the Teflon tube is double reinforced as in Japanese Utility Model Laid-Open No. 58-152914, since the Teflon tube is not in close contact with the Teflon tube, the tube is displaced, and when the curve is further repeated, the cutting occurs. Resulting in.

An object of the present invention is to eliminate such drawbacks of the conventional treatment tools for endoscopes and improve the durability against the case where a force for repeatedly bending the proximal side portion of the insertion portion is applied. An object is to provide a treatment tool for an endoscope that can perform the above.

[0007]

[Means for Solving the Problems]

 The treatment tool for an endoscope of the present invention has an insertion portion formed by extruding and molding a synthetic resin on the outer periphery of a sheath made of a metal coil and closely fixing the same, and a coaxially fixed member at the base end of the insertion portion. And a protection member laminated and fixed to the engagement member. Inside the protection member, a heat shrinkable tubing made of synthetic resin is formed on the outer periphery of the engagement member and the insertion portion base end. It is characterized in that the sleeve is at least double coated.

[0008]

[Action]

 When an unreasonable force is applied to the insertion section by the above configuration, a bending force is applied to the bending prevention tube section, but the vicinity of the insertion section base end is covered with a double heat shrink tube that adheres to the outer peripheral surface. Therefore, the bending force is further reduced.

[0009]

【Example】

 A first embodiment of the present invention will be described with reference to FIGS. FIG. 1 shows the overall configuration of the grasping forceps, FIG. 2 shows the configuration of the distal end portion of the grasping forceps, and FIG. 3 shows the overall configuration of the proximal end portion of the grasping forceps.

The gripping forceps indicated by 1 in the figure is composed of an insertion portion 2 that can be inserted into a forceps channel of an endoscope, and a proximal side operation portion 3 that is connected to the proximal end of the insertion portion 2. There is. The insertion portion 2 is composed of a distal end treatment portion 4 provided on the distal end side thereof for gripping a tissue or a foreign substance in a body cavity, and a flexible sheath portion 5 connected to the distal end treatment portion 4. ing. The operation section 3 is composed of an operation section body 6 for operating the grasping forceps 1 and a liquid delivery mouthpiece section 7 for cleaning the inside of the sheath section 5. A slider 8 for operating the grasping forceps 1 is provided on the proximal side of the operation section body 6 so as to be movable back and forth with respect to the operation section body 6.

As shown in FIG. 2, in the distal treatment section 4, a distal tip 9 which is a distal end main body is connected to the distal end side of the sheath portion 5. The grips 10, 11 are pivotally supported by a shaft 12 on the further tip side of the tip 9. The grips 10 and 11 each have a gripping body that is opened and closed by the operation of the slider 8 to grip the tissue or the like in the body cavity, and arms 10a and 11a connected to the gripping body. The open / close fulcrums of the arms 10a and 11a are rotatably supported by the shaft 12 of the tip chip 9.

An operation wire 13 for transmitting an operation drive force to the distal treatment section 4 is fixed to the slider 8.

The operation wire 13 is inserted through the sheath portion 5 of the insertion portion 2 and connected to the operating member 14 at the distal treatment portion 4. The actuating member 14 is arranged so as to be able to move back and forth in a hole 9a provided in the tip 9 and has a shaft 15 on the tip side.

One ends of a link 16 and a link 17 are rotatably supported on the shaft 15. The other ends of the links 16 and 17 are rotatably supported by shafts 18 and 19 at the rear ends of the arms 10a and 11b, respectively. Then, for example, the shaft 12, the tips 9 and 15, the actuating members 14 and 19, the link 16 and the link 17 are fixed by laser caulking.

The sheath portion 5 is composed of a coil sheath 20 covered with a tube 21. The tube 21 is formed by, for example, extruding and molding a tetrafluoroethylene resin so as to be closely fixed to the outer periphery of the coil sheath 20. Further, the coil case 20 is formed by closely winding a high-strength wire, such as metal, into a coil shape. The proximal end of the coil sheath 20 is attached to the liquid delivery mouthpiece 7, and the distal end is connected to the tip 9. The distal end portion of the coil sheath 20 is fixed to the concave portion 9b by cutting the tube 21 by a depth that fits into the concave portion 9b of the distal end tip 9. Then, the tip end 9 is fixed to the fitting portion by laser welding or the like from the outer circumference thereof. As a result, the outer diameter of the distal tip 9 and the outer diameter of the sheath portion 5 become substantially equal. The outer diameters of the outer peripheries of the grips 10 and 11 are larger than those of the tip 9 and the sheath 5.

As shown in FIG. 3, the proximal side portion of the sheath portion 5 (which forms the insertion portion 2) is press-fitted into the distal end opening of the cylindrical portion of the liquid delivery mouthpiece portion 7 via the cylindrical engagement member 22a. It is connected and fixed by etc. The engagement member 22a is fixed coaxially with the proximal end of the sheath 5 that coaxially covers the operation wire. The outer peripheral surfaces of the sheath portion 5 and the engaging member 22a are doubly covered with a heat-shrinkable tube 23 of synthetic resin so as to be in close contact therewith. A protection member 24 as a tube member for preventing bending is fixed to the outer periphery of the heat shrinkable tube 23 at the end of the sheath portion 5.

The proximal side of the liquid delivery mouthpiece 7 is connected and fixed to the operation portion main body 6 via an engaging member 22b. An O-ring 25 is provided inside the rear end side of this fixed portion. Then, an O-ring stop member 26 is provided inside the rear end of the connecting member 22b. The operation wire 13 is inserted through the inside of the coil case 20, and the operation pipe 27 is covered and fixed on the proximal side. The operation pipe 27 is provided so as to be slidable inside the O-ring 25. Although not shown, the operation wire 13 and the rear end side of the operation pipe 27 are attached to the slider 8.

The operation will be described by taking the gripping operation of the gripping forceps 1 as an example.

When the insertion portion 2 is inserted into the forceps channel, the grasping portions 10 and 11 are endoscopes that can be inserted. Therefore, the distal tip 9 and the sheath 5 have a relatively large clearance with the inner diameter of the forceps channel.

Then, in the case of inserting into a body cavity, for example, the stomach, grasping and taking out a foreign substance, the operating wire 13 advances forward by operating the slider 8 to move the operating member 13 The shaft 15 is displaced forward, and the links 16 and 17 are opened. As a result, the arms 10a and 11a are displaced, and the grip portions 10 and 11 are opened. In this state, the grip body is guided to the position where there is a foreign substance. Then, by operating the slider 8 to retract the operation wire 13 and closing the grips 10 and 11, foreign matter can be gripped.

If an unreasonable force is applied to the sheath portion 5 during gripping, a bending force may be applied to the tip of the operation portion 3. Even in the case as described above, the proximal side of the sheath portion 5 is covered with the double heat-shrinkable tube and the bending preventing tube member 24 is fixed, so that the bending force is reduced. To be done.

As described above, according to the first embodiment, the outer diameters of the tip chip 9 and the sheath portion 5 are smaller than the inner diameter of the forceps channel and are smaller than the outer diameter of the outer periphery of the grip portion main body. Since the clearance is large, the insertion of the insertion part 2 is smooth.

When an excessive force is applied to the sheath portion 5, even if a bending force is applied to the distal end of the operating portion 3, the proximal side of the sheath portion 5 is a double heat-shrinkable tube on the outer peripheral surface. Since the tube member 25 for preventing bending is fixed so that it is tightly adhered to, the bending force is reduced, and the sheath portion 5 has improved durability.

As a first modification of the first embodiment, the inner diameter of the coil sheath 20 may be increased so that the outer diameter remains unchanged. The purpose of this first variant is to improve the passage of water and to make the washing easier and more reliable. That is, the inside of the coil sheath 20 is washed by sending water or the like from the liquid sending mouth portion 7. The water passes through the coil sheath 20 and flows out from the hole 9 a in the distal tip 9. Since the clearance between the inner diameter of the coil sheath 20 and the operation wire 13 is relatively large, the passage of water is improved and the cleaning property is further improved. Other configurations and operations are similar to those of the first embodiment, and thus duplicated description will be omitted.

As a second modification of the first embodiment, the surface of the operation wire 13 may be partially or wholly coated with Teflon. The second modification is intended to improve operability. That is, by operating the slider 8, the operation wire 13 moves back and forth. At that time, the surface of the operation wire 13 and the inner surface of the coil sheath 20 are rubbed with each other. Since the surface of the operation wire 13 is coated with Teflon, the frictional force with the inner surface of the coil sheath 20 is reduced and the slider 8 can be operated with a light force. Other configurations and operations are the same as those in the first embodiment, and thus duplicated description will be omitted.

It goes without saying that the configuration of the present application is not used for the grasping forceps and the high frequency snare described in the embodiments.

For example, it can be used for the proximal end portion of the insertion portion of the hot biopsy forceps.

4 to 7 are views showing a second embodiment. 4 and 5 show the grasping portion 28, FIG. 6 shows the tip portion of the grasping forceps, and FIG. 7 shows a cross section taken along the line AA. The second embodiment will be described below with reference to FIGS. 4 to 7. The second embodiment is different from the first embodiment in that the shape of the grip portion 28 and the actuating member 32 are used in place of the actuating member 14. Other configurations and operations are the same as those in the first embodiment, and thus redundant description will be omitted.

The gripping portions 28 and 29 have a plate shape as shown in FIG. 4, but the taper portion 30 is twisted to form the gripping portions 28 and 29 as shown in FIG.

As shown in FIG. 7, an operating member 32 having substantially the same diameter as the inner diameter of the hole 31 a in the tip 31 is provided so as to be movable back and forth. Then, as shown in FIG. 6, when the length of the actuating member 32 having substantially the same diameter as the hole 31a is L, L is set to be 1 mm to 1.5 mm longer than the normal length. The other structure is the same as that of the first embodiment.

The operation will be described.

The outer circumferences of the grips 28 and 29 are larger than the tip 31. The outer diameters of the gripping portions 28 and 29 on the hand side of the tapered portion 30 are gradually reduced.

Further, similarly to the first embodiment, when opening and closing the grips 28, 29, the operating member 32 advances and retracts linearly in the hole 31a of the tip 31 in the axial direction.

According to the second embodiment, the outer diameter of the outer periphery of the grip portions 28, 29 on the proximal side of the tapered portion 30 is small, and the clearance on the proximal side of the distal end tip 32 is smaller than that of the forceps channel. Since it is large, insertion of the insertion portion 2 is smooth.

The actuating member 32 has substantially the same diameter as the hole 31a in the distal end tip 31 and moves linearly stably in the axial direction, so that the gripping portions 28 and 29 can be opened and closed without swinging. It is possible to reliably grip foreign substances.

8 to 10 are views showing a third embodiment. The third embodiment will be described below with reference to FIGS.

The third embodiment relates to a high-frequency snare 33 that excises a polyp with a high-frequency current. The overall structure is shown in FIG. 8 shows the distal end portion of the insertion portion 34, and FIG. 9 shows the proximal portion of the insertion portion 34.

As shown in FIG. 10, the high-frequency snare 33 includes a sheath-shaped insertion portion 34 and an operation portion 35 connected to the sheath-shaped insertion portion 34. The wire portion 36 is moved forward and backward from the tip of the insertion portion 34. Has been done. The operation portion 35 is detachable from the insertion portion 34, and the wire portion 36 is also detachable from them.

As shown in FIG. 8, the insertion portion 34 of the high frequency snare 33 is formed in the same manner as in the first embodiment. The tip of the tube 37 projects about 1 mm from the tip of the inner sheath 38.

As shown in FIG. 9, an engagement member 39 for detachably fixing the operation portion 35 is adhesively fixed to the proximal end of the insertion portion 34. Then, the outer periphery of the engaging member 39 and the insertion portion 34 was covered with the protective member 40, and the heat-shrinkable tube 41 was doubly arranged between the protective member 40, the insertion portion 34 and the engaging member 39.

On the other hand, the wire portion 36 is composed of a snare wire 42 formed by bending a conductive wire in the middle thereof and an operation wire 43 connected to the snare wire 42. As shown in FIG. 10, the operating portion 35 is composed of an operating portion main body 44 and a slider 45 that can advance and retreat with respect to the operating portion main body 44. The slider 45 is detachably connected to the proximal side of the control wire 34, and the slider 45 is detachably connected to the proximal side of the operation wire 43 via an operation pipe 46. Further, although not shown, the wire portion 36 is electrically connected to the high frequency power source through the slider 45 and a connection cord.

Next, the operation of the third embodiment will be described.

First, after introducing the distal end portion of the endoscope into the body cavity, the insertion portion 34 of the high-frequency snare 33 is introduced through the forceps channel of the endoscope, and the distal end portion of the insertion portion 34 is guided into the body cavity. Put in. During this work, the slider 45 has been pulled fully toward the hand side, so that the snare wire 42 is internally mounted in the insertion portion 34 as shown in FIG.

Then, under the observation of the endoscope, the endoscope is operated to guide the tip of the high-frequency snare 33 to the vicinity of the polyp. After that, when the slider 45 is pushed forward and the snare wire 42 of the wire portion 36 is pushed out from the tip of the insertion portion 34, the snare wire 42 opens in a state of protruding from the tip of the insertion portion 34 as shown in FIG.

After that, the operation of the endoscope and the operation of advancing and retracting the high-frequency snare 33 are combined to hook the snare wire 42 on the polyp, and then the slider 45 is pulled toward the operator's side to pull the snare wire 42 into the insertion portion 34. Tighten the polyp. After that, a high frequency power is supplied to the snare wire 42 from a high frequency power source (not shown) to burn off the polyp. Then, for example, when the snare wire 42 is caught and an unreasonable force is applied when the insertion section 34 is removed from the endoscope, and the bending force of the insertion section 34 is repeated, It is possible to obtain the same effect as that of the insertion portion of the embodiment.

The double heat-shrinkable tube 41 is not limited to the one that covers the outer peripheral surface of the engaging member 22 or the like so as to be in close contact with the outer peripheral surface of the engaging member 22. It may be fixed in close contact with an agent or the like. Further, in the embodiment, the engaging member is fixed to the insertion end base end coaxially, but the present invention is not limited to this and may be eccentric. Further, the engaging member may be integrated with, for example, the liquid delivery mouthpiece portion 7 forming the operation portion.

[0047]

[Effect of device]

 As explained above, even if excessive force is applied to the insertion part, bending force is applied to the insertion part, and even if force is applied to the bending prevention tube, the tube that sticks to the outer peripheral surface near the base end of the insertion part Since it is covered with, the bending force is reduced. Then, the durability of the base end portion of the insertion portion is further improved.

[Brief description of drawings]

FIG. 1 is a perspective view of a treatment instrument for an endoscope showing a first embodiment of the present invention.

FIG. 2 is a cross-sectional view showing the configuration of the grasping forceps on the distal treatment section side.

FIG. 3 is a cross-sectional view showing the configuration of the gripping forceps on the operating portion side.

FIG. 4 is a diagram showing a configuration of a grip portion used in a second embodiment of the present invention.

FIG. 5 is a diagram showing a configuration of a grip portion used in a second embodiment of the present invention.

FIG. 6 is a cross-sectional view showing the configuration of the distal end treatment portion side of the grasping forceps of the second embodiment.

7 is a sectional view taken along the line AA in FIG.

FIG. 8 is a cross-sectional view showing the configuration of the high-frequency snare on the snare wire side.

FIG. 9 is a cross-sectional view showing the configuration of the high-frequency snare on the protective member side.

FIG. 10 is a plan view of a treatment tool for an endoscope showing a third embodiment of the present invention.

[Explanation of symbols]

 5 sheath part 21 tube 22a engaging member 23 heat shrinkable tube 24 protective member

Claims (1)

[Scope of utility model registration request] 1. An insertion part formed by extruding a synthetic resin onto an outer periphery of a sheath made of a metal coil and closely fixing the same, and an engaging member coaxially fixed to the base end of the insertion part. A protective member laminated and fixed to the mating member, wherein the outer periphery of the engaging member and the base end of the insertion portion is at least double-coated with a heat-shrinkable tube made of synthetic resin inside the protective member. A treatment tool for an endoscope.