JPH11342133A - Treatment device for endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a treatment device for an endoscope which can be securely guided to a part such as a narrow tube cavity or a complicated branch part difficult for insertion work and to improve work efficiency. SOLUTION: In a flexible tube 4 having a tip member provided with a cutting edge 13 at a farther end of it, an operation tube 7 and a hollow pipe 8 are inserted advancable and retractable on its center axis, a cutting edge 12 is provided at a closer end of a tip chip 9 installed on a farther end of the hollow pipe 8, so an organization can be cut with the cutting edge 13 facing it, a guide wire 26 can be inserted from a hole 18 at a back end of an operation part 3 along the center axis of the flexible tube 4, so the guide wire 26 is protruded forward the tip chip 9 at the farther end of the hollow pipe 8, and the guide wire 26 is first inserted into a target part of a narrow part or a branch part, thereby the tip side of a sheath part 2 can be guided by the guide wire 26 to be easily and smoothly guided to the target part.

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 which performs a treatment such as tissue collection while observing the endoscope by passing through a channel of the endoscope.

[0002]

2. Description of the Related Art In recent years, endoscopes have been widely used in medical and industrial fields. In particular, in the medical field, an endoscope is inserted into a deep part of a body cavity to observe whether deep tissue is a diseased part. An endoscope is widely used to insert a tissue sampling tool as a treatment tool to collect a target tissue.

[0003] As a prior art of such a treatment instrument for an endoscope, for example, Japanese Patent Application Laid-Open No. 61-279236, Japanese Utility Model Publication 6-2.
1449, Japanese Patent Application No. 7-106646, Japanese Patent Application No. 8-1
05741 and the like.

For example, in Japanese Patent Application Laid-Open No. 61-279236, a distal tip is attached to the distal end of an operation wire that can be advanced and retracted through a hole of a distal end member at the distal end of a flexible tube, and a cutting blade is provided on the rear end side of the distal tip. Discloses a biological tissue collecting tool capable of collecting tissue at a stenosis site.

[0005]

Problems to be Solved by the Invention
In No. 9236, since the distal tip is attached to the distal end of the operation wire, it becomes difficult to pass the distal tip portion through the stenosis in the case of severe stenosis.

For example, when the stenosis portion is long, the load becomes too large unless the distal tip is correctly oriented in the lumen direction of the stenosis portion, and the operation wire or the flexible tube easily kinks and passes through the stenosis portion. May not be allowed.

Also, Japanese Utility Model Publication No. 6-21449, Japanese Patent Application No.
Japanese Patent Application No. 106646/1996 and Japanese Patent Application No. 8-107574 are of a type in which a guide wire is provided along a biopsy forceps and the biopsy forceps is inserted into the stenosis along the guide wire. In some cases, insertion into the stenosis was not successful due to the insertion of the inserted position. Furthermore, at the time of the biopsy, the guide wire may interfere with the operation of the biopsy cup, and the target lesion may not be successfully collected.

(Object of the Invention) The present invention has been made in view of the above-mentioned points, and it is intended to reliably guide even a part where insertion work is difficult, such as a narrow lumen or a complicated branch part. It is an object of the present invention to provide a treatment tool for an endoscope capable of improving the working efficiency.

[0009]

A flexible tube, an operating member which is inserted through the inner space of the flexible tube so as to be able to advance and retreat concentrically,
A distal tip provided at the distal end of the operating member and movable from the distal end member of the flexible tube along the central axis of the flexible tube; and a distal tip provided at the distal end of the distal tip. A spherical portion, a cutting blade provided on at least a part of a periphery of a proximal end of the distal tip, a hollow recess provided inside the cutting blade, and a proximal end side of the operating member, An endoscope treatment tool main body having an operation section for performing an advance / retreat operation of the operation member; and a central axis of the flexible tube, which is provided integrally or freely through the endoscope treatment tool main body. By configuring a treatment tool for an endoscope from a wire-shaped guide member disposed above and projecting from a distal end of the distal end tip, it is easy to approach the stenosis or the like with the wire-shaped guide member. This guide can be used as a guide after passing The distal tip to move along the central axis of the timber can be smoothly perform the work through the stenosis or the like, so that can be easily treatment such collected by cutting with the cutting edge.

[0010]

Embodiments of the present invention will be described below with reference to the drawings. (First Embodiment) FIGS. 1 to 5 relate to a first embodiment of the present invention, and FIG. 1 shows a structure of a biological tissue piece collecting tool according to the first embodiment. 1) shows the structure of the biological tissue piece collecting tool in a cross section at the tip side, and FIG.
FIG. 2A shows a rear view of the grip and shows that the rear end has a hollow structure through which a guide wire can be inserted. FIG. 3 shows a state in which the guide wire is inserted to the vicinity of the stenosis in the lumen. FIG. 4 shows the guide wire of FIG. Shows how it was inserted up to the vicinity,
FIG. 5 shows a state in which the tip of the living tissue piece collecting tool main body is collected from the state shown in FIG.

As shown in FIG. 1, a living tissue piece collecting tool 27 as a first embodiment of an endoscope treatment tool of the present invention includes a living tissue piece collecting tool main body (hereinafter abbreviated as a collecting tool main body) 1. And a guide wire 26 inserted through the sampling tool main body 1. The sampling tool main body 1 is provided on an elongated sheath portion 2 inserted into a channel of an endoscope (not shown) and a proximal end of the sheath portion 2 so that an operator grasps the sheath portion 2 and moves the sheath portion 2 forward and backward. And an operation unit 3 for performing operations such as resection.

The sheath portion 2 includes a flexible coil 5 covered with an elongated cylindrical flexible tube 4 and a flexible coil 5.
Member 6 of a hard member joined to the distal end of the member by brazing or the like
And a flexible operation tube 7 which is inserted into the inner hole of the flexible coil 5 so as to be able to advance and retreat along the center axis thereof, and is nested at the distal end of the operation tube 7 by an adhesive or the like. For example, a hard and cylindrical hollow pipe 8, a distal tip 9 joined to the distal end of the hollow pipe 8 by brazing or the like, and a hollow pipe 8 so as to abut the distal end of the operation tube 7.
And an annular stopper 10 fixed to the outer peripheral surface near the proximal end by brazing or the like.

The proximal end of the flexible coil 5 is
Is fixed to the distal end of the operation section main body 11 by soldering or the like (the fixed state is not shown).

The distal tip 9 has a substantially cylindrical shape with its distal end rounded in a hemispherical shape, and has a cutting edge 12 around its proximal end.
The cutting edge 12 is opposed to a cutting edge 13 provided on the peripheral edge of the distal end of the tip member 6.

The distal end of the tip 9 is joined to a hole provided at the center thereof by brazing or the like at the distal end of the hollow pipe 8, and the operation tube 7 is advanced from the state shown in FIG. As shown in FIG. 2, the distal tip 9 can be advanced (relative to the distal member 6) along the central axis of the flexible tube 4 (in other words, the central axis of the operation tube 7 and the hollow pipe 8). (The tip tip 9 moves forward with respect to the tip member 6 by performing the operation of moving the grip 17 forward with respect to the operation unit body 11).

In this case, the hollow pipe 8 is fitted to the tip member 6 and slides, and the step at the distal end of the stopper 10 provided near the proximal end of the hollow pipe 8 is formed at the proximal end of the tip member 6. Can be advanced (projected forward) from the tip 9 side (relative to the tip member 6) up to the position corresponding to.

Then, as shown in FIG.
A tissue piece to be resected is inserted between 2 and 13 and, for example, an operation of moving the cutting blade 12 to the cutting blade 13 side is performed so that a piece of tissue can be resected. Further, in order to efficiently collect the resected tissue piece, the cutting blade 12,
A hollow space is formed inside the hollow pipe 8 at the outer peripheral portion of the hollow pipe 8 to provide a storage space 14 for storing a tissue piece or the like. In addition, as the configuration of the sheath portion 2, the flexible coil 5 may be omitted and the flexible tube 4 alone may be used.

The operation unit 3 has an operation unit main body 11 having a base 15 serving as an opening end into which a contrast agent or the like is injected, and an operation unit nested to the proximal end of the operation tube 7 with an adhesive or the like. The pipe 16 (the joint state is not shown) and the operation pipe 1
6 and a hollow grip 17 (joint state not shown) joined in a telescopic manner with an adhesive or the like.

Here, the hole 18 at the proximal end of the grip 17
(Refer to FIG. 1 (B)) from the hole 19 at the distal end of the hollow pipe 8.
Up to this point, it has a lumen so that the guide wire 26 and the like can be inserted along the central axis of the flexible tube 4 or the operation tube 7. The distal end of the guide wire 26 is formed in a spherical shape so that it can be easily inserted into a narrow constriction or the like.

The base 15 is composed of the flexible tube 4 of the sheath 2 and the operation tube 7 disposed inside the flexible tube 4.
The contrast agent and the like can be sent to the outside of the biological tissue piece sampling tool 1 from the gap between the distal end member 6 and the hollow pipe 8 because the space 21 communicates with the space 21.

The flexible tube 4 and the operation tube 7
Is polytetrafluoroethylene (PTFE), tetrafluoroethylene / perfluoro / alkoxy / ethylene resin (PF
A), propylene tetrafluoroethylene hexafluoride resin (FE
P), a resin material such as polyethylene, polyamide, and vinyl chloride. Further, regarding the operation tube 7, a material in which a metal wire or the like is embedded in a resin may be used in order to prevent elongation during operation. On the outer surface of the distal end of the operation section main body 11, there is provided a fold-preventing member 22 which is press-fitted in a telescopic manner and serves to prevent the flexible coil 5 including the flexible tube 4 from being broken.

In the present embodiment, the flexible tube 4
An operation tube 7 and a hollow pipe 8 as operation members which are inserted through the inner cavity of the flexible tube 4 so as to be able to advance and retreat concentrically, and provided at the tip of the operation member, A distal tip 9 movable from the distal end member 6 along the central axis of the flexible tube 4, a spherical portion provided at a distal end of the distal tip 9, and a proximal end of the distal tip 9. A cutting blade 12 provided on a peripheral edge, a storage space 14 of a hollow recess provided inside the cutting blade 12, and an operation unit provided on a proximal end side of the operation member for performing an advance / retreat operation of the operation member 3, a sampling tool main body 1 having a wire-like shape provided so as to be inserted through the sampling tool main body 1 and disposed on a central axis of the flexible tube 4 and protruding from a distal end of the distal end tip 9. From the guide wire 26 as a guide member It is characterized in that a tissue sampling tool 27 is formed, and the guide wire 26 is projected from the distal end of the distal end tip 9 to first pass the guide wire 26 through a target site such as a stenosis or a branch. Thus, the distal end tip 9 can be smoothly and reliably guided to the target portion by using the guide wire 2 as a guide.

Next, the operation of the present embodiment will be described, for example, in the case of collecting tissue at a stenosis in a lumen. As shown in FIG. 3, a guide wire 26 is inserted to a position near a stenosis portion 25 in a lumen 24 such as a pancreatic duct (through a forceps channel of an endoscope), and the distal end side of the guide wire 26 is inserted into the stenosis portion 25. Work to pass. In this case, since the guide wire 26 is thin, even if the narrowed portion 25 is made long or the narrowed portion 25 is bent, it is passed through relatively easily even when the narrowed portion 25 is bent. Can be.

Next, as shown in FIG. 4, the collection tool main body 1 is inserted into the hole 19 of the collection tool main body 1 through the guide wire 26 to the vicinity of the stenosis 25 in the lumen 24. An operation of pushing the sheath 2 is performed to advance the distal tip 9 at the distal end of the sheath 2 so that the distal tip 9 passes through the stenosis portion 25.

In this case, the operation of directly passing the distal end tip 9 of the sheath portion 2 through the stenosis portion 25 without using the guide wire 26 as a guide must be performed so as to exactly match the direction of the hole of the stenosis portion 25. In some cases, overloading occurs and the sheath part kinks, making it difficult to pass through.
Since the guide wire 26 is used as a guide, the sheath 2
By simply performing an operation of advancing the stenosis portion 25, it is possible to easily pass the stenosis portion 25 while expanding the stenosis portion 25 with the distal end tip 9 in a state where the guide wire 26 exactly matches the direction of the hole of the stenosis portion 25 through which the guide wire 26 is passed. .

When the distal end tip 9 can be passed through the stenosis part 25, as shown in FIG. Then, the tissue of the stenosis portion 25 is cut off by the cutting edge 12 of the distal end tip 9 and the cutting edge 13 of the distal end member 6, and the cut off tissue piece is stored and collected in the storage space 14 between the cutting edge 12 and the cutting edge 13. can do. In addition, although the case where the tissue of the stenosis part 25 is collected has been described, the tissue can be similarly easily collected by inserting it into a complicatedly branched lumen or the like.

This embodiment has the following effects. When the collection tool main body 1 is inserted into the stenosis 25 or the like along the guide wire 26, the guide wire 26 and the collection tool main body 1 advance and retreat coaxially. The body 1 can be inserted into the stenosis part 25 or the like, and the tissue or the like of the stenosis part 25 or the like can be excised and collected.

That is, since the guide wire 26 is arranged so as to be able to protrude from the distal end tip 6 provided with the cutting blade 12 on the central axis of the sheath portion 2, it is possible to arrange the guide wire 26 in a narrow lumen or a complicated branch portion. It is possible to reliably guide even a part where insertion work is difficult by a simple operation, and work such as tissue collection can be performed quickly and smoothly.

(Second Embodiment) Next, a second embodiment of the present invention will be described below with reference to FIGS. In the first embodiment, the wire-shaped guide member is configured to be inserted into the collection tool main body. On the other hand, in the present embodiment, the collection member main body is integrally provided with the guide member. As shown in FIG. 6, a biological tissue piece sampling tool 31 according to the second embodiment of the present invention includes a sheath portion 32 and an operation portion 33.

The sheath portion 32 includes a cylindrical flexible tube 34, a distal end member 36 nested at the distal end of the flexible tube 34 with an adhesive, or the like. An operation wire 37 that is inserted through the inner hole so as to be able to advance and retreat, a rod 39 that is joined to the distal end of the operation wire 37 by brazing or the like at a connection pipe 38 so as to contact the distal end of the operation wire 37, A distal tip 40 joined to the end by brazing or the like, and a wire-shaped guide portion 41 attached to the distal end of the distal tip 40 so that the center axis of the operation wire 37 coincides with the center axis of the operation wire 37. Have been.

The guide portion 41 has a guide coil 42 joined to the distal end side of the tip chip 40 by brazing or the like, and a distal end for preventing the guide coil 42 from extending in an inner hole of the guide coil 42. And a non-stretch wire 43 fixed at the proximal end by brazing or the like, and the distal end is further processed into a spherical shape. The proximal end of the flexible tube 34 is fixed to the distal end of the operation section main body 46 with an adhesive or the like (the fixed state is not shown).

Proximal end of tip 40 and tip member 3
At the distal end of 6, cutting blades 47 and 48 are formed to face the periphery. A storage space 49 is provided around the rod 39 inside the cutting blades 47 and 48 for storing the excised living tissue and the like.

The operating section 33 includes an operating section main body 46 having a base 50 into which a contrast agent or the like can be injected, and an operating rod 51 (joining) which is connected to the operating wire 37 and the connecting pipe 38 by brazing or the like. The state is not shown) and the operation rod 5
1 and a grip 52 (the bonding state is not shown) bonded with an adhesive or the like.

Here, the grip 52 is the grip 1 shown in FIG.
In the case of 7, there is no guide wire lumen. Further, similarly to the first embodiment, the base 50 is connected to the inner peripheral surface of the flexible tube 34 of the sheath 32 and the operation wire 3.
Since it communicates with the space 53 between the outer peripheral surface of the rod 7 and the outer peripheral surface of the rod 39, the contrast agent or the like can be sent to the outside of the biological tissue piece sampling tool 31 from the gap between the tip member 36 and the rod 39.

Further, by performing an operation of advancing the grip 52 with respect to the operation section main body 46 in the state of FIG. 6, the flexible tube 34 (and the distal end member 36 at the distal end) of the sheath section 32 can be moved. Then, the operation wire 37, the rod 39, the distal tip 40 and the guide portion 41 are connected to the sheath portion 32.
The sheath portion 32 in the forwardly moved state is as shown in FIG.

The flexible tube 34 is made of polytetrafluoroethylene (PTFE), ethylene tetrafluoride perfluoroalkoxy ethylene resin (PFA), ethylene tetrafluoride hexapropylene propylene resin (FEP), polyethylene , Polyamide, vinyl chloride, and other resin materials. A folding member 54 is provided on the outer surface of the distal end of the operation section main body 46, and serves to prevent the flexible tube 34 nested and pressed into the outer surface of the distal end of the operation section main body 46. I have.

In this embodiment, a portion corresponding to the sampling tool main body 1 in the first embodiment corresponds to a portion obtained by removing the guide portion 41 from the sheath portion 32 in FIG. The biological tissue piece collecting tool 31 is provided integrally.
Are formed.

Next, the operation of the present embodiment will be described. FIG.
As shown in (1), a living tissue piece sampling tool 31 is inserted into a lumen 24 such as a pancreatic duct via a forceps channel of an endoscope. next,
As shown in FIG. 9, the guide portion 41 fixed to the distal end tip 40 is inserted into the narrowed portion 25, and the operation of the grip 52 is advanced or retracted as shown in FIG. Cutting edge 47 of the tip member 36 and the cutting edge 48 of the tip member 36
The cut piece is stored in the storage space 49 and collected.

This embodiment has the following effects. First
In addition to the effects of the first embodiment, since the sheath portion 32 does not require an inner hole for a guide wire, the outer diameter can be reduced, so that the approach to the stenosis portion 25 is further improved. Also,
Since the guide portion 41 is integrated, the operation is further improved, and the treatment time can be shortened. The other effects are the same as those of the first embodiment.

As a modification of the second embodiment,
In FIG. 6 or FIG.
The guide portion 41 may be formed so as to project forward from the distal end of the guide portion 41. In this case, the distal end of the rod 39 may be formed into a spherical shape.

In the first or second embodiment, the cutting edge 12 at the proximal end of the tip 9 (or 40) is used.
(Or 47) is not limited to the one provided on the periphery, but may be formed on a part of the periphery.

For example, the proximal end side may be formed in a semi-cylindrical shape, and the cutting edge may be provided at the proximal end and the side portion, and the cutting edge portion may be rotated so that the side cutting edge portion can be cut off. in this case,
For example, the distal end member 6 (or 36) may be provided with the cutting blade 13 (or 48), and may be formed in a cylindrical shape to be fitted to the cutting blade. The tip member 6 (or 36) also includes one in which a cutting blade is not provided. In addition, the present invention includes those in which a treatment section other than the above-described cutting blade is formed.

[Supplementary Notes] A flexible tube, an operating member that is inserted through the inner space of the flexible tube so as to be able to advance and retreat concentrically, and provided at the tip of the operating member. A distal tip movable along the central axis of the flexible tube, a spherical portion provided at a distal end of the distal tip, and a cut provided at least a part of a periphery of a proximal end of the distal tip. With a blade,
An endoscopic treatment tool main body including: a hollow recess provided inside the cutting blade; and an operation unit provided on a proximal end side of the operation member for performing an advance / retreat operation of the operation member. A wire-shaped guide member provided integrally or freely through the treatment instrument body for an endoscope, disposed so as to substantially coincide with the central axis of the flexible tube, and protruding from a distal end of the distal end tip; Endoscope treatment instrument comprising:

2. The treatment tool for an endoscope according to claim 1, wherein the treatment instrument for an endoscope has a structure capable of injecting a liquid medicine such as a contrast agent from the vicinity of the operation unit side and discharging the liquid from the vicinity of the flexible tube tip. 3. 2. The treatment tool for an endoscope according to claim 1, wherein the operation member is a flexible hollow tube through which a guide member can be inserted. 4. The hollow tube is polytetrafluoroethylene (PTFE),
It is made of resin materials such as ethylene tetrafluoride perfluoroalkoxy ethylene resin (PFA), ethylene tetrafluoride hexafluoropropylene resin (FEP), polyolefin, polyamide, vinyl chloride, latex, and natural rubber. 4. The treatment tool for an endoscope according to 3. 5. 5. The endoscope according to claim 4, wherein the hollow tube is made of the resin material and a metal wire such as stainless steel, aluminum, nickel, brass, titanium, iron, phosphor bronze, or tungsten is embedded in the resin. Treatment tool.

6 The treatment tool for an endoscope according to claim 1, wherein a guide member made of a flexible wire elongated in the axial direction is fixed to a distal end of the spherical portion. 7. The guide member made of the flexible wire is stainless steel, aluminum, nickel, brass, titanium, iron,
7. The endoscope treatment tool according to Appendix 6, which is made of a metal such as phosphor bronze or tungsten. 8. The guide member made of the flexible wire is stainless steel, aluminum, nickel, brass, titanium, iron,
Appendix 6 which is a metallic coil of phosphor bronze, tungsten, etc.
The treatment tool for an endoscope according to item 1. 9. 9. The treatment tool for an endoscope according to claim 8, wherein a wire for preventing stretching is fixed to an inner hole of the metal coil at least at a distal end and a proximal end of the metal coil.

10. The guide member made of the flexible wire is made of polytetrafluoroethylene (PTFE) or ethylene tetrafluoride / perfluoro / alkoxy / ethylene resin (PF)
A), propylene tetrafluoroethylene hexafluoride resin (FE
Appendix 6 made of resin materials such as P), polyolefin, polyamide, vinyl chloride, latex, and natural rubber
The treatment tool for an endoscope according to item 1. 11. 7. The treatment tool for an endoscope according to claim 6, wherein a guide member made of the flexible wire is fixed near a central axis of a distal end of the spherical portion. 12. The treatment tool for an endoscope according to claim 1, wherein a cutting edge facing the cutting edge is provided on a peripheral edge of a distal end of the tip member.

[0047]

As described above, according to the present invention, the flexible tube, the operating member inserted through the inner cavity of the flexible tube so as to be able to advance and retreat concentrically, and the distal end of the operating member Provided,
A distal tip that is movable along a central axis of the flexible tube from a distal end member at the distal end of the flexible tube, a spherical portion provided at a distal end of the distal tip, and a vicinity of the distal tip. A cutting blade provided on at least a part of the periphery of the position end, a hollow recess provided inside the cutting blade, and an operation provided on a proximal end side of the operation member to perform an operation of moving the operation member forward and backward. And an endoscope treatment tool main body having: an endoscope treatment tool main body, the endoscope treatment tool main body being provided integrally or freely through the endoscope treatment tool main body, disposed substantially on a central axis of the flexible tube, and Since a wire-shaped guide member protruding from the distal end constitutes a treatment tool for an endoscope, the guide member is protruded from the distal end of the distal end tip so that a target site such as a stenosis portion or a branch portion is formed. The guide member is first passed through the Side can be smoothly and reliably guided to the target region of.

[Brief description of the drawings]

FIG. 1 is a diagram showing a structure of a living tissue piece collecting tool according to a first embodiment of the present invention.

FIG. 2 is a cross-sectional view showing the structure on the distal end side of the biological tissue piece sampling tool main body in a state where the distal tip is advanced.

FIG. 3 is a view showing a state in which a guide wire is inserted to the vicinity of a stenosis in a lumen.

FIG. 4 is a view showing a state in which the guide wire of FIG. 3 is passed through a stenosis portion, and a living tissue piece sampling tool is inserted to the vicinity of the stenosis portion using the guide wire as a guide.

FIG. 5 is a diagram showing a state in which the distal end tip of the biological tissue piece collecting tool is collected through the stenosis portion to collect the tissue of the stenosis portion from the state of FIG.

FIG. 6 is a diagram showing a structure of a living tissue piece collecting tool according to a second embodiment of the present invention.

FIG. 7 is a cross-sectional view showing the structure on the distal end side of the biological tissue piece sampling tool with the distal tip advanced.

FIG. 8 is a view showing a state in which the guide portion is inserted to the vicinity of a stenosis portion in a lumen.

9 is a view showing a state in which the distal end tip is inserted into the vicinity of the stenosis portion using the guide portion of FIG.

FIG. 10 is a diagram showing a state in which the tissue of the stenosis is collected from the state shown in FIG.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... living body piece collection tool main body (collection tool main body) 2 ... sheath part 3 ... operation part 4 ... flexible tube 5 ... flexible coil 6 ... tip member 7 ... operation tube 8 ... hollow pipe 9 ... tip tip 10 ... Stopper 11 ... Operation part main body 12,13 ... Cutting blade 14 ... Storage space 15 ... Base part 16 ... Operation pipe 17 ... Grip 18, 19 ... Hole 21 ... Space 22 ... Break stop member 24 ... Lumen 25 ... Stenosis part 26 … Guide wire 27… Tissue sampling tool

Claims (1)

[Claims] 1. A flexible tube, an operation member that is inserted through a lumen of the flexible tube so as to be able to advance and retreat concentrically, and a distal end of the operation member, the operation member being provided at a tip of the operation member. A distal tip movable from a distal end member along a central axis of the flexible tube, a spherical portion provided at a distal end of the distal tip, and at least a part of a periphery of a proximal end of the distal tip A cutting blade provided in the, a hollow recess provided inside the cutting blade,
An endoscope treatment tool main body, which is provided on the proximal end side of the operation member and has an operation section for performing an advance / retreat operation of the operation member; and integrally or freely inserted into the endoscope treatment instrument body. A wire-shaped guide member provided substantially on the central axis of the flexible tube and protruding from a distal end of the distal end tip.