JPH08126648A - Treatment instrument for endoscope - Google Patents

Abstract

PURPOSE: To provide a treatment apparatus for an endoscope which can easily rotate an apex treatment part in an arbitrary direction. CONSTITUTION: This treatment instrument for an endoscope, which is used through the endoscope and has an operating means which works a clip 2 as an apex treatment part from an operating part at hand side, comprises a wire 33 with torque transmitting properties connecting between the clip 2 and the operating part at hand side and a rotating means for rotating the clip 2 from the side at hand.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a treatment instrument for an endoscope for endoscopically treating a body cavity.

[0002]

2. Description of the Related Art A distal treatment section of a treatment instrument for an endoscope which is inserted endoscopically into a body cavity to treat living tissue has a biopsy section and a grip section. It is a structure that expands by utilizing a link mechanism and springiness. However, it may not be possible to spread the tissue in a direction optimal for the tissue or foreign substance desired to be biopsied or grasped, and it may be difficult to perform the biopsy or grasping. As a treatment tool for solving this problem, as shown in Japanese Utility Model Publication No. 55-109501, a flexible coil is connected to a forceps portion,
There is a flexible coil that can be rotated by using a multi-strand coil or a multiple coil as a portion to be inserted into an endoscope.

[0003]

However, the above-mentioned conventional techniques have the following drawbacks. (A) The forceps are used by being inserted into the forceps channel of the endoscope, and due to the frictional resistance between the outer circumference of the sheath and the inner wall of the forceps channel, a jump in rotation or the like occurs, and the rotational force is reliably applied to the tip. I couldn't tell.

(B) The use of the multi-strand coil and the multi-coil has an influence because the flexibility of the sheath is not a little hard, and thus has an effect.
Since the result is that the insertability into the forceps channel is significantly deteriorated, it has not been possible to obtain the desired rotatability.

(C) The multi-strand coil has a drawback that it cannot rotate depending on the winding direction. (D) In the multiple coils, the coils are stacked in several layers,
Compared to the single-strand coil, it has a drawback of using a radial space. Furthermore, since the forceps channel of the endoscope has a limited space, it is difficult to use a multi-strand coil for the forceps.

(E) In a treatment instrument having no coil, the treatment section cannot be rotated. Further, even in the case of an injection needle that does not have a biopsy part or a grasping part as described above, it is common that the structure of the needle tip cannot be changed, and it is difficult to reliably direct the needle tip to the target site. was there.

The present invention has been made in view of the above circumstances. An object of the present invention is to reliably transmit the rotation by the rotating means provided in the proximal operating section to the treatment section through the wire. An object is to provide a treatment tool for an endoscope that can be used.

[0008]

Means and Actions for Solving the Problems
In order to achieve the above-mentioned object, in an endoscopic treatment tool which is used endoscopically and has an operating means for activating a treatment section at the distal end from a proximal side operation section, a treatment section and a proximal side operation section are provided. It is characterized by comprising a wire having a torque transmitting property for connecting the two and a rotating means for rotating the treatment section from the proximal side. When the rotating means is operated to rotate the wire, the treatment section at the distal end rotates integrally with the rotation of the wire, and the treatment section can be oriented in any direction.

[0009]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 17 show the first embodiment. FIG. 1 is a cross-sectional view of the tip side of a clip device as a treatment tool for an endoscope, which is composed of a main body 1 of the clip device and a cassette-type clip 2. The main body 1 has an introduction tube 3, which is formed of a flexible tube made of tetrafluoroethylene resin or the like so that it can be inserted into a body cavity using a forceps channel of an endoscope. Has become.

FIG. 2 is a perspective view of the hand side operating portion, and FIG. 3 is a sectional view of the hand side operating portion. The base end of the introduction pipe 3 is fixed to the tube joint 4. The tube fitting 4 includes a tube fitting body 5, a tube fitting lid 6, a fixing release button 7,
It is composed of a spring 8 and an O-ring 9. The tube joint body 5 is a conduit 1 having a distal end opening 10 and a proximal end opening 11.
2 and communicates with the lumen of the introduction tube 3.

The conduit 12 is composed of a large proximal end conduit 12a and a small distal end conduit 12b, and the large proximal end conduit 12a has an inner diameter through which the distal end of the operating portion main body 13 can be inserted. The tube joint main body 5 is provided with a luer lock mouthpiece 14 to which a syringe barrel can be attached and detached and which is in fluid communication with the proximal large conduit 12a.

Further, as shown in FIGS. 4 and 5, the tube joint body 5 has two opposite grooves 16 on the base end side of the flange 15, and further has an engaging portion 17 at the base end. There is. In the engaging portion 17, the engaging portion 1 is formed in the same direction as the groove 16.
7 has a side hole 18 which communicates the outer circumference with the large base end pipe 12a. The side hole 18 includes a large diameter portion 19 and a small diameter portion 20.

Next, the tube joint cover 6 has a substantially disc shape, has an opening 21 at the base end side for engaging with the engagement portion 17 at the base end of the tube joint body 5, and has a distal end side. Are provided with projections 22 that engage with the groove 16 of the tube joint body 5 at two locations facing inward. The dimension L from the base end of the flange 15 of the tube joint body 5 to the base end of the tube joint body 5 of FIG.
The dimension L ′ up to the tip of 1 is L> L ′, and about 0.5 mm, L is longer. With this dimension setting,
The tube joint body 5 and the tube joint lid 6 are assembled as follows.

The tube joint lid 6 is slid by aligning the projections 22 of the tube joint lid 6 with the grooves 16 of the tube joint body 5. Since the groove 16 and the protrusion 22 are chamfered 23 and 24 at the beginning of meshing with each other and L> L 'described above, the tube joint lid 6 is deformed as it is slid. Slide it further,
When the center of the flange 15 and the center of the tube joint cover 6 become coaxial, the engaging portion 17 of the tube joint body 5 fits into the opening 21 of the tube joint cover 6, the tube joint cover 6 is not deformed, and The groove 16 and the protrusion 22 are fixed in the radial direction by catching the engaging portion 17 and the opening 21. In this assembled state, the tube joint main body 5 and the tube joint lid 6 are provided with a minimum amount of backlash in all parts, so that there is no residual stress due to the assembly.

Although omitted in the above-mentioned assembling method, the fitting is performed with the tube joint main body 5 loaded with the fixing release button 7, the spring 8 and the O-ring 9. Next, the fixing release button 7, the spring 8 and the O-ring 9 will be described.

As shown in FIGS. 5 and 6, the fixing release button 7 slides a space formed between the engaging portion 17 and the tube joint lid 6 in a state where the tube joint body 5 and the tube joint lid 6 are assembled. It is composed of a moving rectangular frame portion 25 and a pin 26 facing the inside of the frame portion 25. The pin 26 is inserted into the side hole 18 of the engaging portion 17 and has a length of up to about 2 mm protruding into the large-diameter proximal end pipe 12a of the tube joint body 5, and has a minimum protruding length of 0 mm. ing. The pin 26 includes a large diameter portion 26a and a small diameter portion 26b, and an O-ring 9 is inserted between the outside of the small diameter portion 26b and the side hole 18 and the large diameter portion 19 so as to keep watertight. Further, the fixing release button 7 is usually provided with a spring 8 so as to exert an urging force in a direction in which the tip end of the pin 26 projects to the base end large diameter portion 12a.
5 is arranged on the opposite side of the pin 26. By pushing the fixing release button 7 against this biasing force, the protrusion of the pin 26 to the large-diameter base end portion 12a can be set to 0 mm.

Returning to FIG. 2, a heat-shrinkable tube 27 made of a relatively soft material such as silicon is coated from the outer periphery of the base end of the introduction pipe 3 to the tip of the tube joint 4. This is a reinforcement for preventing the introduction pipe 3 from buckling because the hardness of the connection portion between the introduction pipe 3 and the tube joint 4 changes extremely. The hardness of the tube joint 4 and the hardness of the introduction pipe 3 are The purpose is to smooth the changes in.

Returning to FIG. 1, the introduction tube 3 is preferably transparent so that the operation tube 28 inserted through the introduction tube 3 can be seen through the endoscope. If the clearance between the introduction tube 3 and the operation tube 28 is too large, the tube will be deformed and buckled, and if it is small, the sliding resistance will increase. Therefore, it is preferable that the clearance is about 0.1 to 0.5 mm over the entire circumference.

Further, as shown in FIG. 7, the operation tube 28 is a flexible operation member having a connecting ring 29 made of a short tube made of stainless steel or the like attached and fixed to the tip thereof, and can be projected and retracted from the tip of the introduction tube 3. And it is inserted freely to move back and forth. The operation tube 28 is formed by closely winding a stainless wire having a square cross section, and is formed by closely winding a distal end coil 31 having an inner diameter into which the hook 30 can be inserted and a stainless wire having a round cross section. The coil 32 and the coil 32 are fixed to each other by laser welding or the like. As described above, the tip side coil 31 has a large inner diameter so that the hook 30 can be inserted therethrough. Even if the tip side coil 31 is thin, resistance to expansion and contraction and waist strength can be obtained.

The proximal end of the operation tube 28 is connected to the operation section body 13. An operation wire 33 having a torque transmitting property is inserted inside the operation tube 28 so as to be able to move back and forth. The clearance between the operation wire 33 and the proximal coil 32 causes the operation wire 33 to meander in the proximal coil 32,
The clearance is made as small as possible in order to prevent the force transmission force from being impaired, and it is preferably about 0.05 to 0.2 mm.

The base end of the operation wire 33 is the operation pipe 3
4, a slider 36 is rotatably connected to the slider 36 via a wire receiver 35, and a connecting plate 37 of the cassette-type clip 2 is provided at the tip.
A hook 30 is detachably attached to the hook 30. The hook 30 is made by metal injection molding. This is because the metal injection mold is superior in toughness compared to the scraped product, so even if a force more than necessary is applied, it will not break and the broken part will not fall off, it will deform This is because it is enough.

The hook 30 is shown in FIGS. 8 and 9.
As shown in FIG. 5, the tip side is a half-moon shaped portion 38, and the base end side is a columnar portion 39 having a columnar shape. Cylindrical part 3
A hole 40 coaxial with the columnar portion 39 is formed on the base end side of 9. An operation wire 33 is inserted into the hole 40 and is fixed with a fixing material or the like. Further, the flat portion 41 of the half-moon shaped portion 38.
A connecting pin 42 is formed integrally with the flat portion 41 in a direction perpendicular to the flat portion 41. The connecting pin 42 is a cassette type clip 2.
Of the loading section 4 having a substantially oval shape so that the connecting plate 37 of
3 and the connecting plate 37 are composed of a drop-out preventing portion 44 which is larger than the loading portion 43 and prevents the connecting plate 37 from being accidentally detached.

Further, the operating wire 33 is coated with a fluororesin or the like having excellent slipperiness over substantially the entire length, so that the operating wire 33 has good operability. As shown in FIG. 10, the cassette-type clip 2 includes a clip 45, a connecting plate 37 engaged with the clip 45,
It is composed of a clip fastening ring 46.
The clip 45 is formed by bending a thin strip made of stainless steel in the middle portion, and the bent portion serves as a base end portion 47. A pair of fitting portions having a wider spacing than the inner diameter of the clip tightening ring 46 extending from the base end portion 47. 48a, 48b are formed and further extended to allow both arm portions 49a, 49b to tolerance each other. Further, the tip portions of the arm portions 49a and 49b are bent so as to face each other to form sandwiching portions 50a and 50b. Then, the arms 49a and 49b are provided with openness and expandability so as to open the holding portions 50a and 50b.

The connecting plate 37 is formed by punching out a thin strip of stainless steel, one end of which is formed with a J-shaped hook 51 which is engaged with the base end portion 47 of the clip 45, and the other end of which is an operating wire. A daruma-shaped hole 52 that engages with the hook 30 of 33 is formed. Clip tightening ring 46
Is formed by a pipe having a stepped outer diameter so that it can be engaged with and disengaged from the connecting ring 29.
9 is smaller than the inner diameter of 9 and has a large diameter.
It is larger than the inner diameter. Then, the cassette-type clip 2 has a base portion 47 of the clip 45 and a hook 51 of the connecting plate 37.
And the connecting plate 37 to the clip tightening ring 4
6 is inserted from the larger outer diameter, and in that state, the clip tightening ring 46 is filled with a filler made of silicone or the like and temporarily fixed.

Although the operating wire 33 is rotatably fixed to the slider 36, it will be described in detail below. As shown in FIGS. 11 and 12, an operation pipe 34 made of a pipe material such as stainless steel is externally provided at the base end of the operation wire 33 in order to prevent the operation wire 33 from buckling near the slider 36. The operation pipe 34 and the operation wire 33 are folded back together at the base end thereof, inserted into the large-diameter hole portion 53 of the wire receiver 35, and the outer periphery of the wire receiver 35 is caulked to operate the wire receiver 35 and the operation pipe 34. The wire 33 is fixed. Although this can be fixed by soldering or the like, flux or the like is used when soldering, but the operating wire 33 may be corroded and broken due to the residual flux or the like. It is necessary to carry out a scouring process for removing excess solder applied later and a cleaning process for removing the above-mentioned flux and the like.
Fixing by caulking is preferable because this problem can be solved.

The operation pipe 34 has a proximal end portion caulked at a fixed distance from the wire receiver 35 by the rotary pipe 53 on the distal side of the wire receiver 35.
It is fixed to. Of course, this fixing may be done by brazing. The rotary pipe 53 is made of a pipe material such as brass, and has a flat portion 54 over substantially the entire length in the longitudinal direction. That is, the cross-sectional shape is the D cross section.
Further, the surface of the rotary pipe 53 is plated with nickel, chromium or the like. This D cross section transmits the rotation of the later-described rotation operation member 55 to the operation wire 33, and may have a rectangular or hexagonal cross section.

By the way, the operation portion main body 13 has a slider 36.
Has a first slit 56 in a portion where
A second slit 57, into which the rotary operation member 55 is inserted, is provided on the tip side of the first slit 56 in a direction perpendicular to the first slit 56. The rotation operation member 55 has a disk shape, and has a through hole 5 having a D section, which has the same cross-sectional shape as the rotation pipe 53 in the center thereof so that rotation can be transmitted to the rotation pipe 53.
8 is open.

It has been described above that the shape of the rotary pipe 53 may be a square or hexagonal cross-sectional shape. However, when the rotary pipe 53 is square or hexagonal, the shape of the through hole 58 of the rotary operation member 55 is naturally square or hexagonal. Need to change.

The rotary pipe 53 is slidably arranged with respect to the operation portion main body 13 at the center of the second slit 57 in the orthogonal direction, and the rotary operation member 55 has a through hole 58 of the D cross section. The rotary pipe 53 is inserted into the second slit 57 so that the rotary pipe 53 can be moved back and forth. As a result, the rotation of the rotary operation member 55 can be transmitted to the rotary pipe 53 in any state in which the rotary pipe 53 advances or retracts. This rotation force is transmitted to the rotation operation member 55, the rotation pipe 53, the operation pipe 34, the operation wire 33, the hook 30, and the cassette type clip 2.

That is, by rotating the rotation operating member 55 in a state where the clip device is introduced into the body cavity endoscopically, the opening direction of the clip 45 of the cassette type clip 2 can be remotely controlled from outside the body. ing. Although the rotation operation member 55 is provided in front of the portion where the slider 36 slides, this is a position where the operation is easy when the slider 36 is operated with the right hand and the rotation operation is performed with the left hand. Other positions are also acceptable.

By the way, the base end of the operation tube 28 is fixed to the connecting member 59 made of metal on the operating portion main body 13 by brazing or the like, and the connecting member 59 is fixed to the operating portion main body 13 by screwing adhesion. . Since the operation tube 28 is a coil, when it is fixed with an adhesive, the coil may expand and contract due to the expansion and contraction force applied to the coil, and the adhesive may peel off. Therefore, the metal connecting member 59 is once fixed by brazing or the like, and the connecting member 59 is screwed and adhered to the operation portion main body 13. Further, since the operation portion main body 13 is made of resin, it is impossible to directly braze the operation pipe 28 to the operation portion main body 13. A spiral groove 61 is provided at the tip of the threaded portion 60 for performing the screw-on bonding of the connecting member 59, and the spring 6 is provided in the spiral groove 61.
2 is screwed in, and the connecting member 59 and the operation section body 1 described above are screwed.
By simultaneously applying an adhesive agent to the spring 62 arranged in the spiral groove 61 at the time of screwing and adhering with 3, the two adhering steps of the spring 62 and the connecting member 59, and the connecting member 59 and the operating portion main body 13 can be performed at the same time. Is possible.

Next, the tip portion of the operation portion main body 13 has a cylindrical shape having a diameter such that it can be inserted into the proximal large pipe line 12a of the tube joint 4, and the tip portion 63 is opposed to the longitudinal direction. Two guide grooves 64 are provided. The guide groove 64 has a width slightly larger than the diameter of the pin small diameter portion 26b, and the guide groove 64 is deeper in two steps toward the front. This allows pin 2
6 is the first-stage guide groove 64a and the second-stage guide groove 64
By being located at b, the operation pipe 28 is restricted from protruding beyond the introduction pipe 3 beyond this position.

Further, the spring 8 shown in FIG. 5 is dimensioned so as to have a compressive force between the tube joint 4 and the operation portion main body 13 when the pin 26 is at the position of the second guide groove 64b. When the fixing release button 7 is pressed from the state where the pin 26 is positioned in the second-stage guide groove 64b, the pin 2
6 is drawn into the tube joint 4, and the engagement with the guide groove 64b of the second stage is released, and the operation pipe 28 is automatically drawn into the introduction pipe 3 by the biasing force of the spring 62. There is.

By the way, the pin 26 has the guide groove 6 of the first stage.
When located at the tip of 4a, the spring 62 is set so that no compressive force is applied. The biasing force of the spring 62 is such that when the cassette type clip 2 is preset, the introduction pipe 3
It is for pulling in the cassette type clip 2 inside.

It has been stated that two guide grooves 64 are provided at opposite positions on the operation portion main body 13, but this is because the fixing release button 7 and the pin 26 project at 180 ° opposite positions due to their structure. The user tends to think that the pin 26 is located on the fixing release button 7 side, and inserts the tube joint 4 and the operation portion main body 13 in reverse. In order to prevent this, guide grooves 64 are provided on both sides.

By the way, as shown in FIG. 14, in the slider 36, two wire retainers 65 and locking means 6 are provided.
6, a spring 67, and a ratchet release button 68 are provided. The wire retainer 65 uses two identical parts in order to reduce the product cost. The wire retainer 65 enters the first slit 56 of the slider 36,
It is composed of a sliding plate-shaped sliding portion 65a and a half-moon state 65b located on the base end side.

Returning to FIG. 3, the sliding portion 65a is provided with a notch 69, and the wire receiving press 35 is housed in the notch 69 in a state where the two wire receiving presses 65 are combined, and is rotatably fixed. Has been done.

At the tip of the sliding portion 65a, there is an escape portion 70 inside, and also a claw portion 71 facing outward. To fix the slider 36 and the two wire retainers 65, the claws 71 of the wire retainer 65 are attached to the slider 3 from the base end of the slider 36 with the two wire retainers 65 combined.
6 is pushed along the inner cavity groove 72 (see FIG. 13) provided in the inner cavity of No. 6. At this time, the sliding portion 6 is moved by the escape portion 70.
Utilizing that the tip of 5a bends. When the wire retainer 65 and the slider 36 come to predetermined positions, the claw portion 71 is caught by the locking portion 73 of the slider 36, and both are fixed.

The half-moon shaped portion 65b of the wire retainer 65 has a square through hole 75 penetrating the half-moon shaped portion 65b vertically from the half-moon shaped flat portion 74. The ratchet release button 68 and locking means are provided in the through hole 75. 66 and a spring 67 are slidably arranged. Locking means 66 and slider 3
A spring 67 is arranged in a compressed state between the inner wall of the control unit 6 and the inner wall of the control unit 6, and in a normal state, the locking unit 66 is operated by the operation unit main body 1
By being attached to the locking claw 76 of No. 3, the movement of the slider 36 in the front end direction with respect to the operation portion main body 13 is restricted, and a ratchet mechanism is formed.

The ratchet release button 68 is the through hole 7
5 and the communicating hole 7 of the slider 36 communicating with the through hole 75.
By pushing the ratchet release button 68 through the inside of 7, the locking means 66 is pushed up, and the locking means 66 and the locking claw 7
The engagement with 6 can be released.

Further, the sliding portion 6 in the shape of a square rod located in the first slit 56 at the tip of the ratchet release button 68.
It is set so that there is almost no clearance in the longitudinal direction between 8a and the through hole 75. About 0.01 to 0.2 mm is preferable. This is because the slider 36
The cassette type clip 2 is detained, but the J-shaped hook 51 of the cassette type clip 2 extends and the cassette type clip 2 and the main body 1 are separated, but at this time, the force applied to the slider 36 Is released, the slider 36 suddenly moves toward you, and the base end of the slider 36 and the base end of the slit 56 of the operation portion main body 13 collide violently.

At this time, when the clearance is large, the base end of the wire retainer 65 is plastically deformed, the through hole 75 is crushed, and the sliding portion of the locking means 66 and the ratchet release button 68. 68a cannot be slid. In order to prevent this, the clearance is almost eliminated.
Since there is no space for plastic deformation and only elastic deformation is possible, good sliding of the locking means 66 and the sliding portion 68a of the ratchet release button 68 can be ensured even after a sudden collision. Further, by surrounding the two wire retainers 65 with the cylindrical slider 36, the slider 36 is prevented from being separated due to this collision.

By the way, as shown in FIG. 14, the ratchet release button 68 is a retainer 78 toward the button 68b side.
By having a space 79 inside the retainer 78, the retainer 78 can be fitted into the through hole 75 of the wire retainer 65, and the retainer 78 is attached to the step portion 80 of the through hole 75. It is caught and cannot be pulled out.

Next, the operation of the first embodiment will be described with reference to FIG.
16 and FIG. First, the hook 30 is loaded with the cassette-type clip 2, and the cassette-type clip 2 is introduced into the body cavity through the forceps channel in a state where the cassette-type clip 2 is pulled into the introduction tube 3 (state of FIG. 1), and the tube joint 4 is operated. By moving the pin 26 to the front side with respect to the main body 13 and positioning the pin 26 in the second-stage guide groove 64b of the operation portion main body 13, the introduction pipe is pulled forward and the cassette-type clip 2 is removed from the tip of the introduction pipe 3. Stick out.

Next, the slider 36 is moved to the front side of the operation portion main body 13 while ratcheting, the operation wire 33 is pulled and the fitting portions 48a and 48b are drawn into the clip tightening ring 46, and the fitting portions 48a and 48a, When the clip 48b is crushed, the clip 45 is fully opened. In this state, the rotation operation member 55 is rotated in an arbitrary direction so that the leg opening direction of the clip 45 becomes a desired direction. At this time, if the slider 36 is returned to the tip side of the ratchet several times in advance, the rotation can be performed more smoothly.
This is the operation wire 33 for opening the clip 45.
The tension is applied to the ratchet, and this tension is fixed by the ratchet while increasing the frictional resistance between the cassette type clip 2 and the connecting ring 29. This is because the tension can be released by returning a few ratchets.

After the cassette-type clip 2 is opened in the optimum direction by the above operation, the clip 45 is attached to the living tissue.
, And then pull the slider 36 toward you again,
8a, 48b and arm portions 49a, 49b are pulled into the clip tightening ring 46, the holding portions 50a, 50b are closed and completely closed, and then the slider 36 is further pulled toward you. The clip 45 and the clip tightening ring 46 are separated from the clip device body 1 in a state where the hook 51 is plastically deformed and the clip 45 is closed. When the clip device body 1 is pulled out from the endoscope, the clip 45 is noted in the state of gripping the living tissue.

As described above, according to the first embodiment, the distal treatment section can be rotated without impairing the functions other than the rotation, as compared with the method shown in the prior art. Further, the rotation in both directions can be surely performed without the rotation jumping or the like.
Thereby, clipping can be easily performed.

FIG. 17 shows a second embodiment, in which the operation portion main body 81 is made up of two bodies before the portion where the slider 36 slides.
The distal end side operation section main body 81a and the proximal end side operation section main body 81b are rotatably fixed, and the rotary pipe 53, the rotary operation member 55, and the second slit 57 shown in the first embodiment are provided. The difference is that it is not provided in the first embodiment, and other configurations are the same as those in the first embodiment.

This is different from the first embodiment in that the cassette type clip 2 is rotated by holding the distal end side operation portion 81a and rotating the proximal end side operation portion 81b, and other actions and effects are This is the same as the first embodiment.

18 to 21 show a third embodiment, FIG. 18 is an overall view of this embodiment and a sectional view at the tip thereof, and FIG. 19 is a partial sectional view of an operating portion. As shown in FIG. 18 and FIG. 19, an endoscopic treatment tool 100 includes a sheath 101 made of a close-coiled coil having flexibility, a treatment section 102 provided at the distal end of the sheath 101, and a proximal side of the sheath 101. The operation unit 103 provided in the operation unit 10 and the movement of the operation unit 103 are treated by the treatment unit 10.
2 and an operating wire 104 made of a torque transmissive wire inserted inside the sheath 101 in order to transmit the electric power to the sheath 2.

The treatment section 102 includes two link plates 105a,
105b, a pair of gripping members 106a and 106b, two link plates 105a and 105b, and a tip member 107 having a slit for receiving the pair of gripping members, the link plates 105a and 105b, and the operation wire 104 are connected. The connecting member 108 is rotatably fixed by four fitting pins 109. This constitutes a link mechanism.

A ring-shaped locking member 110 is attached to the tip of the sheath 101. By the way, a hole 111 having a diameter slightly larger than the outer diameter of the locking member 110 and slightly longer than the locking member 110 is formed at the base end of the distal end member 107. By caulking the base end of the distal end member 107 from the entire circumference in a state where the sheath 101 having the locking member 110 is inserted into this hole, the distal end member 107 and the sheath 101 are caulked.
Is rotatably fixed.

In addition, the connecting member 108 and the operating wire 104
The fixing hole 1 is provided at the base end of the connecting member 108.
The operation wire 104 is inserted into 12 and fixed by brazing or the like. By the way, the operation unit 103 is the front end operation unit 1.
03a and the base end operating portion 103b. The base end operating portion 103b is provided with a claw 113 at the front end thereof, which is opposite to the front end portion 2a.
It is provided in the place. Also, two or four claws 113
A slit 114 is provided between them so that the claw 113 can bend inward.

Next, a through hole 115 larger than the claw 113 is formed at the base end of the tip operating portion 103a. With this configuration, the proximal end operating portion 103b is inserted into the distal end operating portion 103a while bending the pawl 113, and the pawl 113 and the through hole 1 are inserted.
By engaging with 15, the tip operation portion 103a
And the proximal end operation portion 103b are rotatably fixed.
Further, the operation wire 104 is fixed to the slider 117 via the operation pipe 116 using an adhesive or the like so as not to rotate. Also, instead of the gripping members 106a and 106b, forceps cups 118a and 11 as shown in FIG.
8b is also acceptable.

Next, the operation of the third embodiment will be described. After the treatment section is inserted into the forceps channel of the endoscope and the treatment portion projects from the tip of the endoscope, the operation is performed as follows. First, insert your thumb into the finger ring 119 of the operation unit 103,
When the slider 117 is sandwiched between the index finger and the middle finger of the same hand and the slider 117 is slid back and forth along the shaft portion 120 of the operation portion 103, the operation wire 104 is pulled or loosened in the sheath 101 in the axial direction. , Link plate 10
The treatment section 10 is provided via a link mechanism such as 5a and 105b
Two gripping members 106a, 106b or biopsy cup 1
18a and 118b are opened and closed.
That is, when the slider 117 is pulled, the gripping member 106
a, 106b or biopsy cups 118a, 118b are closed, and when pushed in reverse, they are opened. In addition, the gripping members 106a, 10
6b or the state where the biopsy cups 118a and 118b are opened (the state shown in FIG. 21), the distal end operating portion 103a is held and the entire proximal end operating portion 103b is rotated.
The entire treatment section 102 is rotated via the
06a, 106b or biopsy cup 118a, 118
The opening direction of b is set to an arbitrary direction and closed to grasp a foreign substance in the body cavity or biopsy a tissue.

As described above, according to the third embodiment, the distal treatment section can be rotated without impairing the functions other than the rotation, as compared with the method shown in the prior art. Further, the rotation in both directions can be surely performed without the rotation jumping or the like.
This facilitates biopsy of the tissue.

FIG. 22 shows a fourth embodiment, and is a perspective view showing a partial cross section of a high frequency marking device. The ring-shaped shape of the ring portion 130 and the ring portion 13
A marking portion 131 made of a shape memory alloy that stores a constant angle α with respect to the axial direction at the root of 0, and an operation wire 132 made of a torque transmitting wire connected to the base end of the marking portion 131, and this operation The tube sheath 133 is formed by inserting the wire 132 therethrough, and the marking portion 131 is extended in a straight line to form a tube sheath 133.
It can be pulled inward, and a water supply cock (not shown) is attached to the proximal end of the tube sheath 133. In addition, a plug for connection to a high-frequency device that energizes a high frequency to the marking portion 131 via an operation wire 132 is provided in the operation portion (not shown).

Therefore, the marking portion 131 is linearly extended and introduced into the body cavity endoscopically in a state of being drawn into the tube sheath 133, and the marking portion 131 is moved to the tube sheath 133 by an operation portion (not shown). Further, the hot water is sent to the marking portion 131 through the inner cavity of the tube sheath 133. Due to the heat of the warm water, the marking portion 131 has a ring shape that is a memorized shape and the root of the ring portion 130 has an angle α in the axial direction. Next, the operation wire 132 is rotated to direct the marking portion 131 in a desired direction, and in this state, the ring portion 130 is pressed against the tissue to apply a high frequency to the marking portion 131 via the operation wire 132. A ring-shaped marking is applied to the tissue by the above operation.

According to this embodiment, the ring portion 130 is
The surface of is oriented in the most suitable direction with respect to the tissue to be marked, which allows highly accurate marking. Figure 2
Reference numeral 3 shows a fifth embodiment, which is a sectional view of the tip of a high-frequency incision instrument of the precutting type. The sheath 150 made of a flexible tube, the locking member 151 press-fitted into the inner cavity of the distal end of the sheath 150, and retractable from the inner cavity of the locking member 151, are springy at an angle β with respect to the axial direction. It is composed of a knife portion 152 that is bent with an angle, and an operation wire 154 that is a torque transmission wire attached to the base end of the knife portion 152 via a connection pipe 153.

The locking member 151 has a locking portion 155 having a serrated cross section on the outer circumference, and the locking portion 155 secures the fixing to the sheath 150. The locking member 151 has a large inner diameter portion 151a and a small inner diameter portion 151b. The small inner diameter portion 151b has a diameter in which the knife portion 152 can slide, and the connection pipe 153 cannot be inserted. Also,
A connection pipe 153 can be inserted into the large inner diameter portion 151a. The knife portion 152 has a round bar shape.

The bent portion 156 bent by the angle β is located at a position protruding from the small inner diameter portion 151b in a state where the tip of the connecting pipe 153 abuts against the tip of the large inner diameter portion 151a. Further, although not shown, the proximal end portion has an operation portion for performing an advancing / retreating operation and a rotating operation of the knife portion 152.

Therefore, in order to perform precutting of the duodenal papilla, the operation wire 154 is rotated before the precutting, and the knife portion 152 is oriented in the optimum direction for incision of the duodenal papilla. The operation itself of pre-cutting is well known, and therefore its explanation is omitted.

According to this embodiment, incision of the duodenal papilla leads to bleeding if the incision direction is wrong. Safe pre-cutting is possible because the torque transmitting wire is used and the knife portion can be oriented in the desired direction.

FIG. 24 shows a sixth embodiment and is a sectional view of the tip of a reverse injection type cleaning tube. A sheath 170 made of a flexible tube and a shell-shaped first lumen 1
71 and the second lumen 172, and the first tip member 1 in which one slit 173 is provided on the side wall of the second lumen 172.
74, and a cylindrical distal end lumen 175 is opened with the axis displaced from the distal end side. Further, a second tip member 177, which is in fluid communication with a proximal end lumen 176 that is coaxial with the outer diameter and is opened from the proximal end side, and the distal end side thereof is the distal end members 174, 1
77 is rotatably attached to the sheath 170 on the proximal end side.
The connecting member 178 that is press-fitted and fixed to the first distal end member 174 is fixed by brazing while being inserted into the first inner cavity 171 of the first distal end member 174, and is rotatably inserted to the proximal end in the sheath 170. And an operating wire 179 made of a torque transmitting wire.

The outer diameter of the tip of the second tip member 177 is an inner diameter that can be inserted into the first lumen 171 of the first tip member 174.
It is fixed by brazing etc. in the inserted state. Further, an oblique chamfer 178 is provided on the opposite side of the tip of the second tip member 177 in the direction in which the axis of the tip lumen 175 is displaced, and the chamfer 178 and the slit 173 are fixed so as to face each other. Further, a flange portion 177a is provided on the base end side of the second tip member 177. The connecting member 178 has an inner cavity 180 through which the flange portion 177a can be inserted, and a flange portion 177a is provided at the tip of the inner cavity 180.
Has a locking portion 181 having a diameter smaller than that of the inner cavity 180. By the way, the second tip member 177 is inserted into the connecting member 178, and the second tip member 177 protrudes from the connecting member 178.
It is assembled by attaching the base end of the first tip member 174 to the tip of the tip member 177.

As a result, the tip members 174 and 177 and the connecting member 178 are rotatable. In addition, an operation wire 179 is fixed in the first lumen 171 of the first tip member 174 by brazing or the like.

Therefore, by rotating the operation wire 179, the tip members 174 and 177 are rotated, and the liquid is sent with the slit 173 directed in an arbitrary direction. The liquid is supplied from a water supply mouthpiece (not shown) at the base end of the sheath 170, and water is supplied obliquely rearward from the slit 173 of the first tip member 174 to clean the inside of the body cavity. For this reason, since the tip member can be rotated by the torque-transmissive operation wire 179, liquid can be sent in an arbitrary circumferential direction.

25 and 26 show a seventh embodiment, and FIG. 25 is a sectional view of the tip of an injection needle.
An outer sheath 191 made of a flexible tube having a first inner cavity 190 formed therein and having a narrowed inner diameter by thermoforming, and an inner sheath 192 made of a flexible tube inserted into the outer sheath 191 so as to be able to advance and retract. And consists of an inner sheath 192
A needle 193 having a sharp tip is press-fitted and fixed to the tip.
Further, a pipe 194 made of stainless steel or the like that is locked in the first lumen 190 is fixed to the outer periphery of the needle 193 by soldering or the like. The length of the needle 193 is 4 to 8 mm protruding from the distal end of the outer sheath 191 with the distal end of the pipe 194 abutting the proximal end of the first lumen 190. Further, an operation wire 195 made of a torque transmitting wire is internally provided in the inner sheath 192, and its distal end is attached to the proximal end of the needle 193.

Therefore, the operating wire 195 is rotated by an operating portion (not shown), and the outer sheath 191 is
The inner sheath 192 and the needle 193 are rotated, the needle tip is directed in an arbitrary direction, and the tissue is punctured. The detailed operation of the injection needle is publicly known, and therefore its explanation is omitted.

According to this embodiment, when the injection needle punctures the tissue, the needle is made to face downward of the needle tip as shown in FIG. 26 (a). The puncture is an approach to the tissue from an oblique direction, and as shown in FIG. 7B, if the tip of the needle is peeled upward, it tends to slip on the tissue. Therefore, by using the torque transmitting wire so that the direction of the needle can be changed, reliable puncture can be performed.

FIG. 27 shows an eighth embodiment and is a sectional view of the tip of an injection needle. A tip member 201 attached to the tip of an outer sheath 200 made of a flexible tube and having an internal thread on the inner wall, and a locking member 203 attached to the outer circumference of a needle 202 and having an external thread on the outer circumference are screwed in freely. ing. An inner sheath 204 made of a flexible tube is press-fitted and fixed to the proximal end of the needle 202. Further, an operation wire 205 made of a torque transmitting wire inscribed in the inner sheath 204 is fixed to the base end of the needle 202 by soldering or the like. The needle 2
02 has a total length such that the engaging member 203 is protruded from the tip member 201 by 0 to 8 mm by changing the screwing amount into the tip member 201.

Therefore, by introducing the injection needle transendoscopically into the body cavity and then rotating the operating portion (not shown),
The operation wire 205 is rotated, and the needle 202 is rotated.
The external thread of the needle 202 is screwed into the internal thread of the tip member 201, and varies from 0 to 8 mm from the tip member 201.
After setting the optimum protruding length of the needle 202, the tissue is punctured and various liquids are injected. The detailed operation of the injection needle is publicly known, and therefore its explanation is omitted.

According to this embodiment, the following effects can be obtained in addition to the effects of the seventh embodiment. In the prior art, an injection needle having an arbitrary protruding length was selected and used before being introduced into the body cavity. However, in this embodiment, it is possible to adjust the protrusion length to an arbitrary value while using the endoscope image after introducing it into the body cavity, so that more reliable puncture is possible. Of course, it is also possible to select the protruding length before the introduction.

FIG. 28 shows a ninth embodiment and is a sectional view of the tip of a high-frequency cutting tool. For example, a loop portion 221 made of a stainless wire and formed in a loop shape by providing bent portions 220 at several places, and an operation wire 222 formed of a torque transmitting wire for opening and closing the loop portion 221 are provided. The sheath 223 is formed of a flexible tube that can be insulated. In addition, the loop portion 221 is capable of projecting and retracting in the sheath 223, and at the time of projecting, due to the spring property of the plurality of bending portions 220,
Expand into a loop.

Therefore, after being introduced endoscopically into the body cavity, the loop portion 221 is projected from the sheath 223 and the loop portion 221 is expanded. Next, the operation wire 222 is rotated to adjust the loop portion 221 so that it can be easily attached to a polyp or the like to be cut off. Next, the loop portion 221 is applied to the polyp, and while being tightly bound, a high frequency is energized through the operation unit (not shown) to excise the polyp. The details of the operation are publicly known and will not be described.

According to this embodiment, since the loop surface can be changed in any direction, polyp incision can be easily performed. FIG. 29 shows the tenth embodiment, and shows the tip cross section of the spray type cleaning tube. Via the connecting member 241 to the distal end of the sheath 240 made of a flexible tube,
A tip member 242 is attached. Tip member 242
Is a cylindrical member having a small diameter lumen 243 and a large diameter lumen 244, and the large diameter lumen 244 has an internal thread 24.
Have five. Similarly, the connecting member 241 having a cylindrical shape and a locking portion 246 having a sawtooth-shaped cross section on the outer periphery of the base end and the tip member 242 are fixed to each other, and a space for accommodating the top 247 is provided. The top 247 is fixed in a built-in state. The top 247 has a round bar shape,
A male screw 248 and a spiral groove 249, which is deeper than the female screw 248, are provided on the outer circumferential surface along the entire length in the longitudinal direction.

By fitting the female screw 245 and the male screw 248 with each other, the tip member 242 and the top 247 are rotatably fixed. With this configuration, the lumen 240 of the sheath 240 has the spiral groove 249 and the small diameter lumen 2 of the tip member 242.
It is in fluid communication via 43. Further, at the base end of the top 247, an operation wire 250 made of a torque transmitting wire rotatably inserted in the sheath 240 is fixed. A liquid feeding cock (not shown) is provided at the proximal end of the sheath 240.

According to this embodiment, the liquid is introduced endoscopically into the body cavity, the tip of the cleaning tube is directed to the portion to be cleaned, and liquid is fed into the sheath 240 from the liquid feeding cock. When the fluid to be sent passes through the spiral groove 249, it obtains a flow in the rotational direction. Furthermore, by passing through the small diameter lumen 243 of the tip member 242 having a smaller diameter than the spiral groove 249, the fluid spreads like a shower when discharged from the tip member 242. By the way, at the time of spraying, by rotating the operation wire 250 and screwing the top 247 into the tip member 242, the distance from the tip of the top 247 to the small diameter lumen 243 can be changed. Thereby, the spread angle of the above-mentioned shower-like spray can be changed to an arbitrary angle. Therefore, the spread angle of the spraying can be changed according to the situation at the time of spraying, so that efficient cleaning is possible.

According to the above-mentioned embodiment, the following structure can be obtained. (Supplementary Note 1) In a treatment instrument for an endoscope which is used endoscopically and has an operating means for actuating a treatment section at the distal end from a proximal side operation section, the treatment section and the proximal side operation section are connected. A treatment instrument for an endoscope, comprising: a wire having a torque transmitting property; and rotating means for rotating the treatment section from the proximal side. (Supplementary Note 2) The treatment instrument for an endoscope according to Supplementary Note 1, wherein the treatment section is a ligation section, and the ligation section can be rotated by a wire. (Supplementary Note 3) A wire having a torque transmitting property, which is used transendoscopically and has an operating means for actuating a ligation part at the tip from the operation part main body, and a wire connected to the base end of the wire, with respect to the operation part main body. A treatment instrument for an endoscope including a slider that can move back and forth, a ratchet mechanism arranged in the slider that restricts the slider and the operating portion body from moving back and forth in one direction, and a release button that releases the restriction. In the endoscope treatment tool, the clearance in the front-rear direction with respect to the housing in the slider on which the release button slides is minimized. (Supplementary Note 4) A coil sheath and a tube sheath externally provided on the outer periphery of the coil sheath so as to be capable of advancing and retreating, the ligating portion being detachably attached to the coil sheath, and a spring tube, which can be expanded by springiness, 4. The endoscopic treatment instrument according to appendix 3, which is a ligating instrument including a clip that is drawn into a holding tube by a hook attached to a tip of a wire inserted in a coil sheath so as to be able to move back and forth. . (Supplementary Note 5) The treatment section for an endoscope according to Supplementary Note 1, wherein the treatment section is a biopsy cup, and a wire having a torque transmitting property enables rotation of the expansion direction of the biopsy cup. . (Supplementary Note 6) The treatment instrument for an endoscope according to Supplementary Note 1, wherein the treatment portion is a gripping member, and a wire having a torque transmitting property allows the expanding direction of the gripping member to rotate. (Supplementary Note 7) A flexible sheath, a wire having a torque transmitting property inserted in the sheath so as to be capable of advancing and retracting, and the biopsy cup attached to the tip of the wire via a link mechanism. A treatment instrument for an endoscope according to appendix 6, comprising a distal end processing unit for expanding the biopsy cup by advancing and retreating operation, and having a sheath and a treatment unit rotatable. (Supplementary Note 8) A flexible sheath, a wire having a torque transmitting property inserted in the sheath so as to be capable of advancing and retracting, and the grip member attached to the tip of the wire via a link mechanism to advance and retract the wire. 7. The endoscopic treatment instrument according to appendix 6, comprising a distal end processing section for expanding the gripping member by an operation, wherein the sheath and the treatment section are rotatable. (Supplementary Note 9) The treatment section is a high-frequency incision section, and the high-frequency incision section is constituted by a wire having a torque transmitting property, and the orientation of the incision section can be changed. Mirror treatment tool. (Supplementary note 10) A wire having torque transmission properties is slidably inserted into the sheath in the vicinity of the tip of the insulated flexible sheath, and the wire is inserted from the two side holes to the outer circumference of the sheath. The treatment instrument for an endoscope according to appendix 9, which is formed so as to be exposed and whose distal end is fixed to a sheath distal end cavity, and which is composed of a wire that constitutes the incision. (Supplementary Note 11) A flexible sheath, a distal end member that is rotatably fixed to the distal end of the sheath, and has an internal shape that is formed to guide the sheath lumen in a diagonal direction toward the proximal end side, and is fixed to the distal end member. The treatment instrument for an endoscope according to appendix 1, which is composed of a wire having a torque transmitting property that is rotatably provided inside the sheath. (Supplementary Note 12) The treatment section is an injection needle, which is fixed to a flexible inner sheath and is capable of projecting and retracting from a distal end of a flexible outer sheath that can advance and retreat with the inner sheath. The treatment instrument for an endoscope according to appendix 1, which is rotatably inserted therein and is fixed to an injection needle and is composed of a wire having a torque transmitting property. (Supplementary Note 13) The treatment portion is an injection needle, and the needle and the sheath portion are rotatably attached by a screw, and the needle portion is rotated by a wire having a torque transmission property, whereby the needle from the sheath portion is rotated. The treatment instrument for an endoscope according to appendix 1, wherein the protrusion length of the endoscope is adjustable. (Supplementary Note 14) The treatment section is a high-frequency incision resection section,
The treatment instrument for an endoscope according to appendix 1, wherein the high-frequency incision resection portion is rotatable by a torque having torque transmissibility. (Supplementary Note 15) An insulated flexible sheath, and the high-frequency incision excision portion formed so as to be capable of projecting and retracting in the sheath, having a plurality of bent portions in the wire, and being expandable in a loop shape by a spring property. 15. The treatment tool for an endoscope according to appendix 14, which is attached to the proximal end of the incision resection portion and is composed of a wire having a torque transmitting property and inserted in a sheath so as to be able to advance and retreat. (Supplementary Note 16) The treatment section is a scatter type cleaning section, and the cleaning section is attached to the distal end of the sheath and has a tip member having a tip opening and is screwed into the tip member, and has a spiral groove on the outer periphery. By rotating a wire having a torque transmitting property, which is composed of a top provided and is attached to the base end of the top, the amount of screwing the top into the tip member is varied, and the tip opening of the tip member and the tip of the top are changed. The treatment instrument for an endoscope according to appendix 1, wherein the spraying range can be changed by changing the distance. (Supplementary Note 17) The treatment portion is a high-frequency marking portion, and the high-frequency marking portion is formed of a shape-memory alloy in which a fixed angle is stored in a ring-shaped and ring-shaped base end, and torque transmission is performed at the base end of the high-frequency marking portion. A treatment instrument for an endoscope according to appendix 1, wherein a wire having a mark is attached and the high-frequency marking portion is rotatable. (Supplementary Note 18) The treatment section is a precutting type high frequency incision section, and the high frequency incision section is made of a metal rod that can project from the tip of an insulated tube sheath, and has a bent portion in part. The treatment instrument for an endoscope according to appendix 1, wherein the direction of the high-frequency incision portion can be changed by a wire having torque transmission attached to the end.

[0080]

As described above, according to the present invention, the distal treatment portion is rotated in an arbitrary direction by rotating the proximal end portion of the wire having torque transmitting property disposed in the treatment instrument inner cavity. It can be rotated easily without any jumps. As a result, the ease of the procedure using the treatment tool and the efficiency of the procedure can be improved.

[Brief description of drawings]

FIG. 1 is a vertical sectional side view and a vertical plan view of a tip side of a clip device showing a first embodiment of the present invention.

FIG. 2 is a perspective view of an operation unit of the embodiment.

FIG. 3 is a vertical cross-sectional side view of the operation unit according to the embodiment.

FIG. 4 is a perspective view of a tube joint main body and a tube joint lid of the operating portion of the embodiment.

FIG. 5 is a cross-sectional view of the fixing release button of the embodiment.

FIG. 6 is a perspective view of a fixing release button of the operation unit of the embodiment.

FIG. 7 is a vertical sectional side view of the operation tube of the embodiment.

FIG. 8 is a perspective view of the hook according to the embodiment.

9 is a sectional view taken along the line AA of FIG.

FIG. 10 is a partially cutaway plan view and a partially cutaway side view of the cassette-type clip of the embodiment.

FIG. 11 is a perspective view of the operation wire of the same embodiment.

FIG. 12 is a vertical cross-sectional side view showing a combined state of the operation wire and the wire receiver of the embodiment.

FIG. 13 is a perspective view of a slider of the same embodiment.

FIG. 14 is a cross-sectional view of the slider of the same embodiment.

FIG. 15 is an operation explanatory view of the cassette-type clip of the embodiment.

FIG. 16 is an operation explanatory view of the cassette-type clip of the embodiment.

FIG. 17 is a partially cutaway side view of an operation portion showing a second embodiment of the present invention.

FIG. 18 is a partially cutaway side view showing the entire endoscope treatment tool showing the third embodiment of the present invention.

FIG. 19 is a vertical cross-sectional side view showing the connecting structure of the operation portion of the embodiment.

FIG. 20 is a perspective view of a forceps cup that is a modification of the third embodiment of the present invention.

FIG. 21 is a side view of the forceps cup according to the modification.

FIG. 22 is a perspective view showing marking of the high frequency marking device according to the fourth embodiment of the present invention.

FIG. 23 is a vertical cross-sectional side view of the distal end portion of the high-frequency incision tool according to the fifth embodiment of the present invention.

FIG. 24 is a vertical cross-sectional side view of the distal end portion of the cleaning tube according to the sixth embodiment of the present invention.

FIG. 25 is a vertical cross-sectional side view of the distal end portion of the injection needle of the seventh embodiment of the present invention.

FIG. 26 is an explanatory view of the operation of the embodiment.

FIG. 27 is a vertical sectional side view of the tip portion of the injection needle of the eighth embodiment of the present invention.

FIG. 28 is a vertical cross-sectional side view of the distal end portion of the high-frequency incision tool according to the ninth embodiment of the present invention.

FIG. 29 is a vertical cross-sectional side view of the distal end portion of the spray type cleaning tube according to the tenth embodiment of the present invention.

[Explanation of symbols]

1 ... Main body, 2 ... Cassette type clip, 33 ... Operation wire.

 ─────────────────────────────────────────────────── ─── Continuation of the front page (72) Inventor Yutaka Yanuma 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Inventor Minoru Shinozuka 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Industry Co., Ltd.

Claims (1)

[Claims] 1. A treatment instrument for an endoscope which is used endoscopically and has an operating means for actuating a treatment section at the distal end from a proximal side operation section, wherein the treatment section and the proximal side operation section are connected. A treatment instrument for an endoscope, comprising: a wire having a torque transmitting property, and a rotating means for rotating the treatment section from the proximal side.