JPH1142232A - Treatment utensil for endoscope having curve - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a treatment utensil for endoscope having a curve, the insertion property of which is improved, and which can be surely inserted to a target area without damaging the inside of a body cavity, e.g. a bronchia wall. SOLUTION: This treatment utensil for endoscope comprises a tip end treatment part 23, a tip end coil 25 which extends from the tip end treatment part 23, a rear end coil 26 which extends from the tip end coil 25 to an at-hand side operation part, and an operation wire which extends from the tip end treatment part 23 through the insides of the tip end coil 25 and the rear end coil 26 to the at-hand side, and is connected to the at-hand side operation part. The treatment utensil for endoscope has an angle wire 31 one end of which is fixed to the outside of the tip end treatment part 23, and which extends to the at-hand side along the tip end coil 25, and then, goes through the rear end coil 26 from the vicinity of the connected part between the tip end coil 25 and the rear end coil 26, and extends to the at-hand side, and is connected to a curved operation part, and a cover 32 comprising an elastic member, which covers at least a part of the angle wire 31, is provided.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a treatment instrument which is inserted endoscopically into a body cavity and collects a diseased tissue or the like, and more particularly to a treatment instrument for an endoscope with a curved end coil.

[0002]

2. Description of the Related Art In a treatment instrument for transendoscopically inserting into a body cavity and collecting an affected tissue, a treatment instrument for a curved endoscope capable of bending a distal end coil is conventionally shown in FIGS. It is configured as follows. That is, the treatment tool 1 for an endoscope with a curved portion has a distal end portion mainly composed of a sheath 2 made of a tightly wound coil having flexibility and a distal treatment portion 3 provided on the distal end side. The close-wound coil of the sheath 2 includes a distal coil 5 having a small outer diameter and a rear coil 6 having a large outer diameter.

The distal treatment section 3 includes a distal sleeve 7 fixed to the distal end of the sheath 2, and a pair of biopsy cups 9 pivotally connected to the distal sleeve 7 by a pivot pin 8 so as to be opened and closed.
a and 9b. This biopsy cup 9a, 9b
Is designed to extend inside the sheath 2 to the proximal side and open and close by pushing and pulling an operating wire (not shown) connected to a proximal operating section (not shown).

A distal end of the angle wire 10 is fixed to the outer periphery of the distal sleeve 7. The angle wire 10 passes through the rear end coil 6 and is connected to a not-shown bending operation unit provided in a not-shown proximal operation unit.

[0005] Next, a method of using the bending endoscope treatment tool 1 will be described. In bronchoscopy, in order to collect tissue present in the peripheral branch 11 of the bronchus,
It is necessary to selectively insert the curved endoscope treatment tool 1 into the bronchus 12 that is complicatedly branched. Therefore, as shown in FIG.
0 is pulled toward the rear end side of the endoscope treatment tool with a bend 1 to bend the bending portion 4 so that the distal treatment section 3 is directed toward the peripheral branch 11, and then the treatment tool for an endoscope with a bend. Step one.
By repeating this procedure, a desired peripheral branch 11 is reached. Thereafter, the above-mentioned operation wire (not shown) is pushed and pulled to open and close the biopsy cups 9a and 9b, and a tissue at a desired site can be collected.

[0006] A tissue sampling tool in which the sampling brush at the distal end is bendable is known from Japanese Utility Model Publication No. Sho 56-10329, and measures the length of an affected part in a body cavity at the distal end of a flexible tube. A length measuring device for an affected part in a body cavity in which a length measuring member is provided to be bendable is known from Japanese Utility Model Laid-Open No. 47-16286.

[0007]

However, when the bending instrument 4 is bent, the angle wire 10 is shaped like a bow of a bow as shown in FIG. 17 when the bending instrument 4 is bent. In other words, the width A of the curved portion formed by the bent portion 14 of the distal end coil 5 and the angle wire 10 is much larger than the outer diameter of the bending endoscope treatment tool 1.
For this reason, there is a disadvantage that the insertability into the peripheral branch 11 which is a relatively narrow lumen is deteriorated.

Normally, a thin stainless single wire is used for the angle wire 10. However, as shown in FIG. 17, there is a possibility that the angle wire 10 may abut on the bronchial wall when bent, thereby damaging the bronchial wall. there were.

Further, bronchial endoscopy was performed using a tissue sampling brush for an endoscope disclosed in Japanese Utility Model Publication No. Sho 56-10329, and as shown in FIG.
When the tissue is collected from the lesions existing in the bronchus 5 and 16, since the bronchus 18 have a structure that repeats intricately and repeatedly, the tissue collecting brush 17 is used to reach the desired site.
Must be selectively inserted into the peripheral branches 15 and 16.
That is, the tip of the tissue collection brush 17 is
When the number reaches 9, the tip of the tissue collecting brush 17 is turned by a bending mechanism provided in the tissue collecting brush 17 and inserted into any of the peripheral branches 15 and 16.

However, as shown in FIG. 18, in the tissue collecting brush 17, the brush portion 20 is formed by twisting the wire with the brush bristles and the tip of the brush is relatively sharp. And cannot pass through the bronchial bifurcation 19 smoothly.
There is a risk of damaging the bronchial wall.

When the size of a lesion is confirmed before performing endoscopic mucosal resection (EMR) using a measure for an endoscope disclosed in Japanese Utility Model Laid-Open Publication No. 47-16286, a measure forceps is used. Since the size of the lesion cannot be measured unless it is pressed against the lesion itself or in the vicinity of the lesion, the lesion may be deformed depending on how it is pressed, and it is difficult to measure the exact size.

In addition, since the measuring forceps has a scale on the bar-shaped measuring portion, the measuring direction is one-dimensional, and two-dimensional measurement, that is, simultaneous measurement in vertical and horizontal directions cannot be performed. .

The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a bending endoscope treatment instrument which can be easily and safely inserted into a complicatedly branched body cavity or a peripheral branch of a bronchus. Is to provide.

[0014]

In order to achieve the above object, the present invention provides a distal treatment section, a distal coil extending from the distal treatment section, and extending from the distal coil to a proximal operation section. A bending endoscope treatment tool comprising a rear end coil and an operation wire extending from the distal treatment section to the proximal side through the distal end coil and the rear end coil and connected to the proximal operation section; Is fixed to the outside of the distal treatment section, extends proximally along the distal coil, extends proximally through the rear end coil from near the connection between the distal coil and the rear coil, An angle wire connected to the bending operation unit provided on the proximal operation unit, and at least a part of the distal coil and the angle wire are covered, fixed to the distal treatment unit on the distal side, and connected to the distal coil on the rear end side. End coil connection Characterized by comprising a cover made of an elastic member fixed beside.

Since the distal end coil and at least a part of the angle wire are covered with the flexible cover, even if the bending endoscope treatment instrument is bent by inserting it into, for example, a bronchus, the width of the bending portion is not increased, and the angle is not increased. The bronchi can be inserted into the peripheral bifurcation without directly contacting the wire with the bronchial wall.

[0016]

Embodiments of the present invention will be described below with reference to the drawings. 1 and 2 show a first embodiment. FIG. 1 shows a distal end portion of an endoscope treatment instrument 21 with a curve, and FIG. 2 shows a state in which the endoscope treatment instrument 21 with a curve is inserted into a bronchus 35. Is shown. The distal end portion of the curved endoscope treatment tool 21 is roughly divided into a flexible tightly wound coil sheath 22 and a distal treatment section 2 provided on the distal end side thereof.
It consists of three.

The tightly wound coil of the sheath 22 is
And a rear end coil 26 having a small outer diameter and a rear end coil 26 having a large outer diameter. Further, the front end coil 25 and the rear end coil 26 are connected via a connection sleeve 27.

The distal treatment section 23 comprises a distal sleeve 28 fixed to the distal end of the sheath 22, and a pair of biopsy cups 30a and 30b pivotally connected to the distal sleeve 28 by a pivot pin 29 so as to be opened and closed. I have. The biopsy cups 30a and 30b are opened and closed by pushing and pulling an operation wire (not shown) inserted through the sheath 22. The distal end of the angle wire 31 is fixed to the outer periphery of the distal sleeve 28.

On the other hand, a cover 32 is provided on the bending portion 24 so as to cover the tip coil 25 and the angle wire 31. The cover 32 is a flexible and thin-walled tubular member, for example, silicone rubber, polytetrafluoroethylene (PTFE), or tetrafluoroethylene / perfluoroalkyl vinyl ether copolymer (PFA). The cover 32 is adhesively fixed on the distal end side to the distal end sleeve 28 and on the rear end side to the connection sleeve 27.

In the present embodiment, a biopsy cup is provided in the distal treatment section 23, but there is no particular limitation. For example, the distal treatment section 23 may be a grasping forceps, a cell sampling brush, or the like.

Next, the operation of the bending endoscope treatment instrument 21 configured as described above will be described. As shown in FIG. 2, the bending endoscope treatment tool 21 is inserted into the bronchus 35, and the angle wire 31 is pulled to the rear end side of the bending endoscope treatment tool 21 at the bronchial branch 33. 2
4 is bent so that the direction of the distal treatment section 23 is changed to the peripheral branch 34.
Then, the bending endoscope treatment tool 21 is advanced. By repeating this procedure, a desired peripheral branch 34 is reached. Thereafter, the operation wire (not shown) is pushed and pulled to open and close the biopsy cups 30a and 30b, and a tissue at a desired site is collected.

When the angle wire 31 is pulled to the rear end side of the endoscope treatment tool with a bend 21 and the bend 24 is bent, the width B of the bend of the tip coil 25 and the bend formed by the angle wire 31 is obtained. Is limited by the cover 32 to a size sufficient to be inserted into the peripheral branch 34. Bending part 2
Since the fourth angle wire 31 is located inside the cover 32, it does not directly touch the bronchial wall.

According to this embodiment, since the width B of the curved portion is regulated by the cover 32, the insertability of the bronchus 35 into the peripheral bifurcation 34 is improved while maintaining the same bending performance as that of the prior art. In addition, since the angle wire 31 does not directly touch the bronchial wall, the curved endoscope treatment tool 21 can be inserted without damaging the bronchus 35.

FIGS. 3 to 6 show a second embodiment, and FIGS.
4 and 4 show the distal end portion 37 of the tissue collection brush 36, and FIGS. 5 and 6 show a state where the tissue collection brush 36 is inserted into the bronchus 46. As shown in FIGS. 3 and 4, the tissue sampling brush 36 includes a cup portion 38 and a sleeve 39. The cup portion 38 is pivotally attached to a sleeve 39 by a pivot pin 40. A sheath 41 extends from the sleeve 39 to a hand-side operation unit (not shown). And FIG.
As shown in FIG. 5, when the brush wire 42 is pulled toward the user, the cup portion 38 is bent, and the direction of the tip can be changed.

A brush wire 42 is provided at the tip of the cup 38.
Are fixed by, for example, bonding or soldering. After the brush wire 42 extends to the proximal side substantially in parallel with the long axis of the cup portion 38, the brush wire 42 passes through the sleeve 39 and passes through the sheath 41.
It extends inward and is connected to a not-shown operation unit (not shown).

The brush wire 42 is formed of a wire folded back at the tip, and a brush portion 44 is formed by twisting the bristles 43 of the brush. The portion where the bristle 43 of the brush is twisted is formed to have substantially the same length as the cup 45 of the cup portion 38.

Next, the operation of the tissue sampling brush 36 configured as described above will be described. As shown in FIGS. 5 and 6, the tissue sampling brush 36 is inserted into the bronchus 46.
At this time, since the radius of curvature of the tip of the cup portion 38 is relatively large and smooth, as shown in FIG.
When the distal end of the tube 6 reaches the bronchus bifurcation 47, even if the tissue sampling brush 36 is further pushed in, it is smoothly inserted into the peripheral bifurcation 48 without damaging the bronchial wall of the bronchus bifurcation 47 as shown in FIG. When the distal branch 48 has a large branch angle and cannot be inserted only by pushing, the brush wire 42 can be pulled into the hand to bend the distal end and be inserted into the peripheral branch 48.

According to this embodiment, the tissue sampling brush 36
Can smoothly and safely pass through the bronchial branch 47. FIG. 7 shows a third embodiment, in which the tip of a tissue sampling brush 49 is shown. The configuration of the tissue sampling brush 49 of the present embodiment is the same as that of the second embodiment except for the sheath 50, and the sheath 50 is formed of a multi-strip coil in which about 3 to 6 strands are wound.

According to this tissue sampling brush 49, as shown in FIG. 6, when the distal end reaches the bronchial bifurcation 47, the bending direction does not coincide with that of the peripheral bifurcation 48 to be inserted. At this time, if the hand-side operation unit is rotated at this time, since the sheath 50 is formed of a multi-strand coil, the direction of the distal end 51 also rotates with good followability, and the distal branch 4
8 and the bending direction can be matched.

Therefore, in addition to the effects of the second embodiment, it is possible to realize a desired improvement in insertability into a peripheral branch. FIG.
9 and FIG. 9 show a fourth embodiment, in which a tissue collection brush 52 is used.
2 shows the tip of the device. The tissue collection brush 52 of the present embodiment includes:
The configuration other than the outer sheath 53 is the same as that of the second embodiment. The outer sheath 53 has an inner diameter through which the tissue sampling brush 52 can be inserted and removed, and is formed of a flexible tube member that can be inserted into a forceps channel of an endoscope. Outside Seeds 5
Reference numeral 3 extends from the tip of the tissue sampling brush 52 to the vicinity of a hand-side operation unit (not shown), and as shown in FIG.
Has a length capable of protruding from the outer sheath 53.

The material of the outer sheath 53 is, for example, polytetrafluoroethylene (PTFE) or a tetrafluoroethylene / perfluoroalkylvinyl ether copolymer (PFA).

As shown in FIG. 9, the distal end portion 54 of the tissue collection brush 52 is connected to an outer sheath 53 as shown in FIG.
6 and inserted into the peripheral branch 47 together with the outer sheath 53 in the same manner as in the second embodiment shown in FIG. After reaching the desired peripheral branch 47 and harvesting the tissue,
The tissue sampling brush 52 is pulled into the outer sheath 53 as shown in FIG. Then, the tissue sampling brush 52 and the outer sheath 53 are removed from the bronchi 46 and the endoscope together.

Therefore, in addition to the effects of the second embodiment, contamination (mixing of other tissues) at the time of extraction after tissue extraction can be prevented, and more accurate tissue extraction can be realized.

FIGS. 10 to 13 show a fifth embodiment.
FIG. 10 shows the distal end portion 56 of the tissue sampling brush 55. The configuration of the tissue sampling brush 55 of the present embodiment is the same as that of the second embodiment except for the tip 56. FIG. 11 shows the cup portion 57.
12, FIG. 12 is a view of the cup portion 57 viewed from a direction C in FIG. 11, and FIG. 13 is a side view in which the tip of the brush portion 58 is enlarged.

The tip portion 56 of the brush portion 58 is provided with a tip 59. The tip 59 has a cylindrical shape with flanges at the front and rear, and the tip of the brush wire 60 is fixed. The bristles 61 of the brush are twisted on the brush wire 60 as in the second embodiment.

At the tip of the cup portion 57, a keyhole-shaped cutout portion 62 is provided. The notch portion 62 has a parallel portion 63 having a width slightly smaller than the outer diameter of the cylindrical portion of the tip 59,
A circular portion 6 having the same inner diameter as the outer diameter of the cylindrical portion of the tip 59
I have four.

As shown in FIG. 10, the tip 59 of the brush 58 is fixed to the notch 62 of the cup 57 so as to be detachable and not easily come off. In addition, the brush wire 60 extends to a not-shown operation unit (not shown) and is detachably fixed to the operation unit.

As described above, since the brush portion 58 is detachable on the tip side and the rear end side of the tissue sampling brush 55, only the brush portion 58 needs to be replaced when the brush bristles 61 are deteriorated. There is no need to replace the entire 55. In addition, when the tissue collection brush 55 is reused, if the previously used tissue collected from the patient remains in the brush unit 58, the tissue is mixed, which causes a problem that accurate tissue analysis cannot be performed. The problem can be solved by replacing the brush portion 58. That is, in addition to the effects of the second embodiment, this embodiment can realize an economical and low-contamination risk tissue collection brush.

FIGS. 14 and 15 show a sixth embodiment, and show endoscope measures 65 and 66. FIG. The endoscope measures 65 and 66 are made of a flexible and thin base material. Base material is paper, elastomer,
Alternatively, it is a paper-based one coated with an elastomer.

The size and shape of the endoscope measures 65 and 66 can be, for example, a circle having a diameter of 1 to 30 mm.
This does not apply if the size is appropriate for the lesion to be measured.

The scales of the endoscope measures 65 and 66 are as follows.
For example, a grid-like scale 67 as shown in FIG. 14 or a concentric scale 68 as shown in FIG. 15 can be printed on the base material, but as long as the scale is appropriate for the lesion to be measured. Absent. The scales can be provided on both front and back sides of the endoscope measures 65 and 66. The color of the base material and the scale can be, for example, yellow for the base material and black for the scale. Absent.

Accordingly, the measures 65 and 66 for the endoscope can be placed transendoscopically near the lesion, and the size of the lesion and the measures 65 and 66 for the endoscope can be compared and measured. In particular, the base material is an elastomer, or
In the case where paper is used as a base material and its surface is coated with an elastomer, it is placed endoscopically in a folded state and then quickly restored to its original shape in a body cavity.

According to this embodiment, since the measurement can be performed without strongly pressing the lesion or the vicinity of the lesion, the size can be accurately measured without deforming the lesion. In addition, two-dimensional measurement, that is, vertical and horizontal spread can be measured simultaneously.

The material of the base material of the endoscope measures 65 and 66 in the sixth embodiment is paper, an elastomer, or a paper base with an elastomer coating on the surface. Therefore, in the case of abdominal endoscopic surgery, even if it is left in the body after measurement, it is absorbed by the living body. Therefore, in addition to the effect of the sixth embodiment, since it is safe for the living body and does not need to be collected, a simpler measurement method can be provided.

Further, if the materials of the endoscope measures 65 and 66 are corn starch, the digestive tract can be digested and discharged even if it is placed in the digestive tract in gastrointestinal endoscopy. Therefore, in addition to the effect of the sixth embodiment, since it is safe for the living body and does not need to be collected, a simpler measurement method can be provided.

According to the above-described embodiment, the following configuration is obtained. (Supplementary Note 1) Through the distal treatment section, the distal coil extending from the distal treatment section, the rear coil extending from the distal coil to the proximal operation section, and passing through the distal coil and the rear coil from the distal treatment section. In the treatment tool for an endoscope, which extends to the proximal side and includes an operation wire connected to the proximal operation section, one end is fixed to the outside of the distal treatment section and after extending to the proximal side along the distal coil. An angle wire extending from the vicinity of the connection portion between the tip coil and the rear end coil to the proximal side through the interior of the rear end coil and connected to a bending operation unit provided in the proximal side operation unit; and a tip coil and an angle wire. Characterized by comprising a cover made of an elastic member that covers at least a part of the front end portion, is fixed to the distal treatment section on the distal end side, and is fixed on the rear end side in the vicinity of the connection portion between the distal coil and the rear coil. Endoscope treatment tool.

(Supplementary Note 2) The treatment instrument for a curved endoscope according to Supplementary Note 1, wherein the cover is made of a fluororesin. (Supplementary Note 3) The bending endoscope treatment tool according to Supplementary Note 1, wherein the cover is made of polytetrafluoroethylene. (Supplementary Note 4) The treatment instrument for a curved endoscope according to Supplementary Note 1, wherein the cover is made of a tetrafluoroethylene / perfluoroalkylvinyl ether copolymer.

(Supplementary note 5) The treatment instrument for a curved endoscope according to Supplementary note 1, wherein the cover is made of silicone rubber. (Supplementary note 6) The treatment tool for a curved endoscope according to any one of Supplementary notes 1 to 5, wherein a biopsy forceps is provided in the distal treatment section. (Supplementary note 7) The bending endoscope treatment tool according to any one of Supplementary notes 1 to 5, wherein a grasping forceps is provided in the distal treatment section. (Supplementary note 8) The bending endoscope treatment tool according to any one of Supplementary notes 1 to 5, wherein a cell collection brush is provided in the distal treatment section. (Supplementary note 9) The treatment tool for a curved endoscope according to any one of Supplementary notes 1 to 5, wherein a sharp spoon for cell collection is provided in the distal treatment section.

(Supplementary Note 10) A cup portion having a smooth tip, a sleeve in which the cup portion is rotatably pivoted by a pivot pin, a sheath extending from the sleeve to the hand side, and the sheath An operation unit provided at the hand side end,
The tip is fixed to the tip of the cup part, extends to the proximal side almost parallel to the long axis of the cup part, then extends through the sleeve to the proximal operating part through the sheath, and the proximal end to the proximal operating part A brush wire fixed to the cup portion and provided such that the bristles are located in the cup portion. (Supplementary Note 11) The tissue sampling brush for an endoscope according to Supplementary Note 10, wherein the brush portion is detachable. (Supplementary Note 12) The tissue sampling brush for an endoscope according to Supplementary Note 10 or 11, wherein the sheath is formed of a multi-strand coil.

(Supplementary Note 13) The tissue collection brush has an inner diameter that can be inserted and removed, and an outer diameter that can be inserted into a forceps channel of an endoscope. 13. The tissue sampling brush for an endoscope according to any one of supplementary notes 10 to 12, further comprising an outer sheath made of a flexible tube member having a length capable of protruding a tip portion of the sampling brush from the tip. (Supplementary Note 14) The tissue sampling brush for an endoscope according to supplementary note 13, wherein the outer sheath material is made of a fluororesin. (Supplementary note 15) The tissue sampling brush for an endoscope according to supplementary note 13, wherein the outer sheath material is made of polytetrafluoroethylene. (Supplementary Note 16) The outer sheath material is tetrafluoroethylene /
14. The brush for collecting tissue for an endoscope according to supplementary note 13, wherein the brush is made of a perfluoroalkyl vinyl ether copolymer.

(Supplementary note 17) For an endoscope, which is made of a flexible and thin base material, has a size that can be folded and inserted endoscopically, and has a scale on at least one surface. major. (Supplementary note 18) The endoscope measure according to Supplementary note 17, wherein the scales are in a grid shape. (Supplementary note 19) The endoscope measure according to supplementary note 17, wherein the scale is concentric. (Supplementary Note 20) The endoscope measure according to any one of Supplementary Notes 17 to 19, wherein the base shape is circular.

(Supplementary note 21) The endoscope measure according to supplementary note 20, wherein the base has a diameter of 1 to 30 mm. (Supplementary note 22) The endoscope measure according to any one of supplementary notes 17 to 21, wherein the base material is paper. (Supplementary note 23) The endoscope measure according to any one of Supplementary notes 17 to 21, wherein the base material is an elastomer.

(Supplementary note 24) The endoscope measure according to any one of Supplementary notes 17 to 21, wherein the base material is formed by coating paper with an elastomer. (Supplementary note 25) The endoscope measure according to any one of Supplementary notes 17 to 21, wherein the base material is made of a bioabsorbable material. (Supplementary note 26) The endoscope measure according to any one of Supplementary notes 17 to 21, wherein the base material is made of corn starch. (Supplementary note 27) The endoscope measure according to any one of supplementary notes 17 to 26, wherein the surface of the base material is yellow and the scale color is black.

According to Supplementary notes 1 to 9, by providing a cover on the bending portion, the insertion performance can be improved while maintaining the bending performance similar to that of the prior art, and the inside can be inserted without damaging the bronchial wall. An endoscope treatment tool can be provided.

According to Supplementary notes 10 to 16, it is possible to provide a tissue sampling brush that can pass through the bronchial bifurcation smoothly and safely by smoothing the shape of the tip of the tissue sampling brush. According to Supplementary Notes 17 to 27, two lesions
An endoscope measure that can be measured dimensionally and accurately can be provided.

[0056]

As described above, according to the present invention, by providing a cover at the bending portion of the endoscope treatment tool with bending, the insertability is improved while maintaining the bending performance similar to that of the prior art. And it can be reliably inserted into a target site without damaging a body cavity, for example, a bronchial wall.

[Brief description of the drawings]

FIG. 1 is a partially cut-away side view of a distal end portion of a curved endoscope treatment tool according to a first embodiment of the present invention.

FIG. 2 is an operation explanatory view showing a state in which the endoscope treatment tool with a bend of the embodiment is inserted into a bronchus.

FIG. 3 is a partially cut-away side view of a tip of a tissue sampling brush showing a second embodiment of the present invention.

FIG. 4 is a side view of the tip of the tissue sampling brush of the embodiment.

FIG. 5 is an operation explanatory view showing a state in which the tissue sampling brush according to the embodiment is inserted into bronchi.

FIG. 6 is an operation explanatory view showing a state in which the tissue sampling brush according to the embodiment is inserted into a bronchus;

FIG. 7 is a side view of a distal end portion of a tissue sampling brush showing a third embodiment of the present invention.

FIG. 8 is a side view of the tip of a tissue sampling brush showing a fourth embodiment of the present invention.

FIG. 9 is a side view of a tip portion of the tissue sampling brush showing the embodiment.

FIG. 10 is a longitudinal side view of a tip of a tissue sampling brush showing a fifth embodiment of the present invention.

FIG. 11 is a longitudinal sectional side view of a cup portion of the tissue sampling brush showing the embodiment.

FIG. 12 is a view as seen from the direction of arrow C in FIG. 11;

FIG. 13 is an enlarged side view of the brush unit of the embodiment.

FIG. 14 is a front view of a base of an endoscope measure according to a sixth embodiment of the present invention.

FIG. 15 is a front view of a base of the endoscope measure according to the embodiment;

FIG. 16 is a partially cut-away side view of a distal end portion of a conventional curved endoscope treatment tool.

FIG. 17 is an operation explanatory view showing a state where the endoscope treatment tool with a bend is inserted into a bronchus.

FIG. 18 is an operation explanatory view showing a state in which a conventional tissue sampling brush is inserted into a bronchus.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 21 ... Bending endoscope treatment tool 22 ... Sheath 23 ... Tip treatment part 24 ... Bending part 25 ... Tip coil 26 ... Rear end coil 31 ... Angle wire 32 ... Cover

Claims (1)

[Claims] 1. A distal treatment section, a distal coil extending from the distal treatment section, a rear coil extending from the distal coil to a proximal operation section, and a distal coil and a rear coil extending from the distal treatment section. An endoscopic treatment instrument comprising an operation wire connected to the operation side connected to the operation side, which is extended to the proximal side through the inside, one end of which is fixed to the outside of the distal end treatment section, along the distal end coil. Angle extending from the vicinity of the connection portion between the front end coil and the rear end coil to the hand side through the inside of the rear end coil, and connected to the bending operation portion provided in the hand side operation portion. A wire and a cover made of an elastic member that covers at least a part of the distal coil and the angle wire, is fixed to the distal treatment section on the distal side, and is fixed near the connection between the distal coil and the rear coil on the rear side. Comprising A treatment tool for an endoscope with a curve, characterized in that: