JPH1170122A - High frequency incision and abscission instrument - Google Patents

Abstract

PROBLEM TO BE SOLVED: To relieve pain to be given to a patient by preventing a nonuniformity from occurring in the projecting direction of a piercing part in a piercing needle at the time of assembling a high frequency incisal wire and efficiently execute work for positioining and fixing the high frequency incisal wire to a mucosa in a short time. SOLUTION: A piercing part 11a projected toward the outside of the loop of the high fequency indisal wire 8 along the coaxial direction of the center axis in a flexible tube 2 and a wire connecting part 11b where a tip bending part 10 is formed by an internally mounting possible tube body so as to restrict the projecting direction of the piercing part 11a are provided in an exterior member 11 which is mounted on the tip bending part 10 of a tip in the high frequency incisal wire 8.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a high-frequency incision and resection tool for incising and resecting a lesion in a body cavity with a high-frequency incision wire to which a high-frequency current is applied.

[0002]

2. Description of the Related Art Generally, a high-frequency incision and resection tool is connected to a distal end of an operation wire inserted in a flexible tube so as to be able to advance and retreat. Here, the high-frequency incision wire is provided to be able to protrude and retract from the distal end of the flexible tube.

For example, Japanese Patent Publication No. 6-20463 discloses a technique for joining a metal stud to the leading end of a high-frequency incision wire by soldering or welding. Further, Japanese Utility Model Laid-Open No. 5-58111 discloses a technique in which a metal needle is joined to a distal end portion of a high-frequency incision wire by brazing.

[0004]

In the above-mentioned conventional method, a metal stud or a puncture needle is joined to the tip of a high-frequency incision wire by means of welding, soldering, brazing or the like. It is difficult to regulate the directivity of the needle, that is, the protruding direction of the puncture portion of the needle because it is just welded, and there is a problem in that the protruding direction of the puncture portion of the needle is varied in assembling the high-frequency incision wire.

[0005] Here, for example, when the protruding direction of the puncture portion of the needle is deviated from the coaxial direction with the central axis of the flexible tube arranged on the plane of the loop formed by the high-frequency incision wire, the operation wire is pushed in. When operated, the force for piercing the puncture part of the needle into the mucous membrane in the body cavity escapes, and there is a problem that it takes time to fix the high-frequency incision wire to the mucous membrane.
For this reason, there is also a problem that the patient may be given unnecessary pain or, over time, the saline may fall out of the lesion portion raised by the saline, and the treatment may not be performed.

Further, when the puncture part of the needle is pierced into the mucous membrane in the body cavity, the force for piercing the puncture part of the needle into the mucous membrane in the body cavity escapes, and the protrusion or the needle is inserted into the mucous membrane to a sufficient depth. Because it is not possible, the fixed part at the tip comes off the puncture part while tying the surrounding area of the lesion with a high-frequency incision wire,
There is also a problem that the position of the high-frequency incision wire shifts or comes off the mucous membrane. In such a case, unnecessary resection of the mucous membrane or resection of the lesion site cannot be completely performed, which may hinder diagnosis or leave the lesion site behind.

The present invention has been made in view of the above circumstances, and an object of the present invention is to prevent a variation in the projecting direction of a puncture portion of a puncture needle when assembling a high-frequency incision wire, and to apply a high-frequency incision wire to a mucous membrane. An object of the present invention is to provide a high-frequency incision and resection tool which can efficiently perform the operation of fixing the position in a short time and reduce the pain given to the patient.

[0008]

According to the present invention, a high-frequency incision wire is connected to a distal end of an operation member inserted into a flexible tube so as to be able to advance and retreat, and the high-frequency incision wire is connected to the flexible member by operating the operation member. In the high-frequency incision and resection tool provided so as to be able to protrude and retract from the distal end of the tube, a high-frequency incision wire is provided at the front end thereof with a high-frequency incision wire bent at the front end thereof. A puncture portion formed by the high-frequency incision wire and protruding outward from a loop along a central axis of the flexible tube, and a puncture portion having a shape capable of housing a bent end portion of the high-frequency incision wire; A high-frequency incision and resection tool provided with a wire connection portion for regulating a projecting direction of the high-frequency incision. By regulating the projecting direction of the punctured portion by the shape of the wire connection portion of the mounting member at the distal end of the high-frequency incision wire, the projecting direction of the punctured portion can be arranged on the loop surface formed by the high-frequency incision wire. It can be easily formed in a state where it is correctly oriented coaxially with the central axis of the flexible tube.

[0009]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, a first embodiment of the present invention will be described with reference to FIGS. 1 (A) to 1 (D) and 2 (A) to 2 (D). FIG. 1A shows a schematic configuration of the entire high-frequency incision and resection tool 1 of the present embodiment.

The high-frequency incision and resection tool 1 of the present embodiment is provided with an elongated flexible tube 2 which is a sheath inserted into a body cavity of a patient. The flexible tube 2 is formed of a material having electrical insulation such as, for example, tetrafluoroethylene resin.

The proximal end of the flexible tube 2 is provided with a hand-side operation unit 3. The operation unit 3 is provided with a substantially linear slider guide member 4. A substantially linear guide groove 4a is formed in the axis of the slider guide member 4. Further, a slider 5 is attached to an outer peripheral portion of the slider guide member 4 so as to be slidable in the axial direction of the slider guide member 4.

The slider 5 is provided with an electrode 6. A base end of an operation wire member (operation member) 7 which is inserted into the flexible tube 2 so as to be able to advance and retreat is connected to the electrode 6. The distal end of the operation wire member 7 is connected to a high-frequency incision wire 8 described later.

An external high-frequency power supply (not shown) is connected to the electrode 6 of the slider 5. The operation wire member 7 also serves as a lead wire for conducting a high-frequency current from the high-frequency power supply to the high-frequency incision wire 8.

Further, the high-frequency incision wire 8 is previously provided with a bending habit of expanding in an elliptical loop shape, for example. The main part of the treatment section 9 of the high-frequency incision and resection tool 1 disposed at the distal end of the flexible tube 2 is formed by a loop of the high-frequency incision wire 8.

The treatment section 9 constructed as above is operated as follows. That is, the operation wire member 7 is moved with the sliding operation of the slider 5 of the operation unit 3 on the hand side.
Is operated in the flexible tube 2, and the high-frequency incision wire 8 is operated to protrude and retract from the distal end of the flexible tube 2 with the operation of the operation wire member 7.

Here, when the slider 5 of the operation section 3 is retracted to the base end side, the operation wire member 7 is pulled toward the hand side, and the high-frequency incision wire 8 formed in a loop shape is flexible. It is drawn into the tube 2. Therefore, the loop of the high-frequency incision wire 8 is elastically deformed in a state of being elongated and crushed, and is housed inside the flexible tube 2. Operation unit 3
When the slider 5 is advanced to the distal end side, the high-frequency incision wire 8 is projected outward from the distal end of the flexible tube 2,
It expands into an open loop and returns to its original shape.

Further, at the tip of the high-frequency incision wire 8,
As shown in FIG. 1B, the wire is bent to form a bent end portion 10. Further, an external member (mounting member) 1 shown in FIG.
1 is attached. The external member 11 has a puncture portion 11a and a wire bonding portion 11b.

Here, the wire joining portion 11b is formed by a tube body in which the bent portion 10 of the high-frequency incision wire 8 can be housed. That is, the inner diameter D ₁ of the tube at the wire joint portion 11 b is formed to be substantially the same as the outer diameter of the bent end portion 10 of the high-frequency incision wire 8.

The projecting direction of the puncture portion 11a of the external member 11 is coaxial with the center axis of the flexible tube 2 on the plane of the loop formed by the high-frequency incision wire 8, and is disposed outward of the loop. . The puncture portion 11a is, for example, 3 to
The length is set to about 0.5 mm.

Further, when assembling the external member 11 to the bent end portion 10 of the high-frequency incision wire 8, the front end bent portion 10 of the high-frequency incision wire 8 is installed inside the wire joint portion 11 b of the external member 11. 1 (D)
The high-frequency incision wire 8 is formed by crimping the tube of the wire joint portion 11b into a flat shape as shown in FIG.
And the external member 11 are joined and fixed. At the time of this joining operation, the tip bent portion 10 of the high-frequency incision wire 8 is inserted into the tube of the wire joining portion 11b, so that the projecting direction of the puncture portion 11a is on the loop plane formed by the high-frequency incision wire 8. In a direction coaxial with the center axis of a certain flexible tube 2, the state is regulated so as to be directed outward from the loop. As a result, the protruding direction of the puncture portion 11a of the external member 11 is coaxial with the center axis of the flexible tube 2 on the loop plane formed by the high-frequency incision wire 8, and the high-frequency incision is performed in a state where the high-frequency incision wire is regulated outward. The wire 8 and the external member 11 are easily joined and fixed.

Next, the operation of the above configuration will be described.
Here, a method of resecting a lesion 21 in a patient's body cavity using the high-frequency incision resection tool 1 of the present embodiment will be described with reference to FIGS.

First, with the loop of the high-frequency incision wire 8 housed inside the flexible tube 2, the flexible tube 2 is inserted into an endoscope channel (not shown) and inserted into the body cavity of the patient. In this state, the lesion 21 is observed by an endoscope.
Is found, the lesion 21 is raised by local injection of physiological saline.

Subsequently, the slider 5 of the operating section 3 is advanced in the direction of the distal end, so that the high-frequency incision wire 8 is projected outward from the distal end of the flexible tube 2. By this operation, the high-frequency incision wire 8 restores the loop shape and expands.

In this state, as shown in FIGS. 2A and 2B, an operation of hooking the treatment section 9 of the high-frequency incision and resection tool 1 on the lesion 21 is performed. 2A is an initial state of the operation of hooking the treatment section 9 on the lesion 21, and FIG. 2B is a puncture portion 11 a of the external member 11 of the high-frequency incision wire 8.
Respectively show the state of having punctured the surface of the body cavity. At this time, the high frequency incision is performed by puncturing the external member 11 of the high frequency incision and resection tool 1 of the present embodiment into the puncture site 23 on the surface of the body cavity on the other side of the body cavity surface over the lesion 21 raised by the physiological saline. The bent end portion 10 of the wire 8 is fixed to the body cavity surface.

Thereafter, the flexible tube 2 is pushed out toward the front end. At this time, the bent end portion 1 of the high-frequency incision wire 8
0 is fixed to the puncture site 23 of the mucous membrane by the external member 11, so that the loop shape of the high-frequency incision wire 8 is set with respect to the central axis of the flexible tube 2 as indicated by an arrow in FIG. Will be spread out at right angles.

Further, from this state, the distal end portion of the flexible tube 2 is pressed against the mucous membrane 22 on the near side of the lesion 21 as shown in FIG. 2 (D). At this time, since the bent end portion 10 of the high-frequency incision wire 8 remains fixed to the mucous membrane 22 by the external member 11, the bent end portion 10 of the high-frequency incision wire 8 does not warp, and the high-frequency incision wire 8 does not warp.
The entire lower surface facing the mucous membrane 22 of the
And the peripheral portion thereof is sufficiently pressed against the root of the raised portion.

Thereafter, in this state, the high-frequency incision wire 8 is drawn back into the flexible tube 2 by retracting the slider 5 to the proximal end side, so that the raised lesion 21 is removed by the high-frequency incision wire 8.
Tighten with. As a result, the lesion 21 sandwiched between the high-frequency incision wires 8 and the normal tissue 24 around the lesion 21 can be cut off.

Also, during the operation of fastening the raised lesion 21 with the high-frequency incision wire 8, the slider 5 is retracted and the flexible tube 2 is advanced at the same time, so that the raised lesion 21 and its peripheral portion are high-frequency incision wire. Until the last time when the wire 8 is sufficiently tied up, the external member 11 at the tip of the high-frequency incision wire 8 does not come off the puncture site 23.

Therefore, the above configuration has the following effects. That is, in the high-frequency incision cutting tool 1 of the present embodiment, the external member 11 at the distal end of the high-frequency incision wire 8 is used.
The protrusion direction of the puncture portion 11a of the external member 11 can be restricted by the tube of the wire connection portion 11b in the above. It can be accurately formed outwardly of the loop in a direction coaxial with the central axis of the tube 2. Therefore, a force for pressing the external member 11 against the puncture site 23 in the patient's body can be easily applied via the operation wire member 7, so that the external member 11 can be reliably punctured into the puncture site 23. Therefore, the hard mucous membrane 22,
It is arranged on the other side beyond the raised lesion 21,
The external member 11 can be reliably positioned at the puncture site 23 that is difficult to confirm from the visual field of the endoscope.

Further, in the high-frequency incision and resection tool 1 of the present embodiment, an external member 11 separate from the high-frequency incision wire 8 is provided, and this externally attached member 11 is assembled to the bent portion 10 of the high-frequency incision wire 8. Therefore, the external member 11 can be manufactured at low cost, and the high-frequency incision wire 8 can be easily assembled.

Further, since the rigidity of the external member 11 is easily ensured, the external member 11 is disposed on the other side beyond the hard mucous membrane 22 or the raised lesion 21 so that it is difficult to confirm the puncture site 23 from the view of the endoscope. There is also an effect that the work of puncturing the attachment member 11 is easily performed.

FIG. 3 shows a first embodiment (FIG. 1).
(See (A) to (D) and FIGS. 2 (A) to (D)) showing a first modification of the high-frequency incision and resection tool 1. In this modification, the high-frequency incision wire 8 of the treatment section 9 of the high-frequency incision and resection tool 1 is configured to be bent so as to expand in a polygonal loop such as a hexagon.

Further, the shape of the puncture portion 11a of the external member 11 of the high-frequency incision and resection tool 1 is the same as that of the second modification of the high-frequency incision and resection tool 1 of the first embodiment shown in FIG. It may be needle-shaped. Further, a third modification of the high-frequency incision and resection tool of the first embodiment shown in FIG. 4B, or a fourth modification of the high-frequency incision and resection tool of the first embodiment shown in FIG. 4C. A configuration in which a notch is formed in the pipe to make it sharp as in a modified example may be adopted. A configuration may be adopted in which the wire joint portion 11b of the external member 11 and the bent end portion 10 of the high-frequency incision wire 8 are joined and fixed by welding or brazing.

FIGS. 5A and 5B show the second embodiment of the present invention.
1 shows an embodiment of the present invention. This embodiment is similar to the first embodiment (FIGS. 1A to 1D and 2A to 2 A).
The configuration of the external member 11 of the high-frequency incision and resection tool 1 (see (D)) is changed as follows. FIG.
In (A) and (B), portions having the same configuration as in the first embodiment are denoted by the same reference numerals, and description thereof is omitted here.

That is, the external member 11 of the present embodiment
In FIG. 5A, a cutout portion 11c shown in FIG. 5 (A) is formed in a part of a tube of a wire joining portion 11b in which the bent end portion 10 of the high-frequency incision wire 8 can be housed. Here, the inner diameter D ₂ of the tubular body of the wire joint portion 11 b is formed to be substantially the same as the outer diameter of the distal bent portion 10 of the high-frequency incision wire 8.

Further, the puncturing portion 11a of the external member 11
Is formed on the end face of the tube at the wire joint portion 11b by cutting out from a metal plate.
Is formed by bending a metal plate into a pipe shape.

When the wire joint portion 11b of the external member 11 is joined to the bent end portion 10 of the high-frequency incision wire 8, the wire joint portion 11b is provided with the tip bent portion 10 of the high-frequency incision wire 8 inside. 5 (B)
By caulking the outer peripheral portion of the wire joining portion 11b as shown in (1), the high-frequency incision wire 8 and the external member 11 are joined and fixed.

The wire connecting portion 1 of the external member 11
A configuration may be adopted in which a portion between the end portion 1b and the bent portion 10 of the high-frequency incision wire 8 is joined or fixed by welding or brazing.

Therefore, the above configuration has the following effects. That is, in the present embodiment, the external member 1
1 is joined to the bent end portion 10 of the high-frequency incision wire 8,
The protruding direction of the puncturing portion 11a is regulated by the fitting portion of the wire joining portion 11b of the external member 11 and the tube, so that the protruding direction of the puncturing portion 11a is changed to the high-frequency incision wire 8
Can be correctly positioned outward of the loop in the same direction as the center axis of the flexible tube 2 on the plane of the loop formed by. Therefore, similarly to the first embodiment, the external member 1
Since it becomes easy to apply a force that presses the external member 11 to the puncture site 23 in the patient's body, the external member 11 can be reliably punctured into the puncture site 23. Therefore, the external member 11 can be reliably positioned at the puncture site 23 which is arranged on the other side of the hard mucous membrane 22 or the raised lesion 21 and which is difficult to confirm from the visual field of the endoscope.

Further, in this embodiment, the external member 11
The puncture portion 11a is formed on the end face of the tube of the wire joining portion 11b by cutting out a metal plate, and the wire joining portion 11b is formed by bending the metal plate into a pipe shape. The attaching member 11 can be manufactured at low cost, and the assembly of the high-frequency incision wire 8 is easy.

The wire connecting portion 1 of the external member 11
When the outer peripheral portion 1b is crimped, the notch 11
Since the outer diameter of the wire joining portion 11b can be prevented from expanding due to c, the outer diameter of the wire joining portion 11b can be easily caulked in accordance with the inner diameter of the flexible tube 2. Therefore, the outer diameter of the wire joint portion 11b can be easily restricted to the outer diameter that can be inserted into the flexible tube 2.

Furthermore, since the rigidity of the external member 11 can be easily ensured, the external member 11 is disposed on the other side beyond the hard mucous membrane or the raised lesion 21 and is difficult to confirm from the visual field of the endoscope. The member 11 can be reliably positioned.

FIGS. 6A to 6C show a third embodiment of the present invention.
1 shows an embodiment of the present invention. This embodiment is similar to the first embodiment (FIGS. 1A to 1D and 2A to 2 A).
The configuration of the external member 11 of the high-frequency incision and resection tool 1 (see (D)) is changed as follows. Note that FIG.
In (C), portions having the same configuration as in the first embodiment are denoted by the same reference numerals, and description thereof is omitted here.

That is, the external member 11 of the present embodiment
A pair of flat plate-like holding pieces 31 which are bifurcated into wire bonding portions 11b of the external member 11 and are arranged to be spaced apart and opposed to each other.
a and 31b are provided. Further, each holding piece 31
Projections 32 for retaining are formed at the ends of a and 31b.

When assembling the external member 11 to the bent end portion 10 of the high-frequency incision wire 8 of the high-frequency incision cutting tool 1, each of the holding pieces 31a, 3 of the external member 11 is attached.
In a state where the bent end portion 10 of the high-frequency incision wire 8 is sandwiched between 1b, as shown in FIG.
The projection 32 of the base 31b is bent so as to be located between the end portions of the bent end portion 10. As a result, as shown in FIG. 6C, each of the holding pieces 31a, 3a of the wire bonding portion 11b is formed.
The external member 11 is joined and fixed to the high-frequency incision wire 8 in a state where the bent portion 10 of the high-frequency incision wire 8 is held between 1b.

The wire connecting portion 1 of the external member 11
A configuration may be adopted in which a portion between the end portion 1b and the bent portion 10 of the high-frequency incision wire 8 is joined or fixed by welding or brazing.

Therefore, the above configuration has the following effects. That is, in the present embodiment, the external member 1
A pair of holding pieces 31a, 31 of one wire bonding portion 11b
b, the projecting portion 32 of each of the holding pieces 31a, 31b, and the engaging portion of the high-frequency incision wire 8 and the bent portion 10 of the high-frequency incision wire 8 regulate the projecting direction of the puncturing portion 11a.
Of the flexible tube 2 on the plane of the loop formed by the high-frequency incision wire 8, and can be correctly positioned outward of the loop. Therefore, the first
In the same manner as in the embodiment, a force for pressing the external member 11 against the puncture site 23 in the patient can be easily applied, so that the external member 11 can be reliably punctured into the puncture site 23. Therefore, the external member 11 can be reliably positioned at the puncture site 23 which is arranged on the other side of the hard mucous membrane 22 or the raised lesion 21 and which is difficult to confirm from the visual field of the endoscope.

Further, in this embodiment, the external member 11
Is easy to assemble to join the bent end portion 10 of the high-frequency incision wire 8 and the rigidity of the external member 11 is easily ensured. Therefore, it is arranged on the other side beyond the hard mucous membrane 22 or the raised lesion 21. Thus, the external member 11 can be reliably positioned at the puncture site 23 that is difficult to confirm from the visual field of the endoscope.

FIGS. 7A and 7B show a fourth embodiment of the present invention.
1 shows an embodiment of the present invention. This embodiment is similar to the first embodiment (FIGS. 1A to 1D and 2A to 2 A).
The configuration of the external member 11 of the high-frequency incision and resection tool 1 (see (D)) is changed as follows. Note that FIG.
In (C), portions having the same configuration as in the first embodiment are denoted by the same reference numerals, and description thereof is omitted here.

That is, the external member 11 of the present embodiment
Is provided with an elongated plate member 41 as shown in FIG. Protrusions 42 are formed at both ends of the plate 41 to prevent the plate 41 from coming off.

When assembling the external member 11 to the bent portion 10 of the high-frequency incision wire 8 of the high-frequency incision cutting tool 1, the center of the plate 41 is bent so as to be located between the bent portions 43 a and 43 b on both sides of the plate 41. 7 with the bent end portion 10 of the high-frequency incision wire 8 interposed therebetween.
As shown in (B), the projections 4 of the bent portions 43a and 43b
2 is bent so as to be located between the end portions of the bent end portion 10. Thereby, the bent portions 43 on both sides of the plate material 41
a, bent portion 1 of high-frequency incision wire 8 between a and 43b
The external member 11 is joined and fixed to the high-frequency incision wire 8 with the “0” pinched. At this time, the punctured portion 11a is formed by the bent portion of the plate member 41 of the external member 11, and the wire bonding portion 11b is formed by the bent portions 43a and 43b of the plate member 41.

The wire connecting portion 1 of the external member 11
A configuration may be adopted in which a portion between the end portion 1b and the bent portion 10 of the high-frequency incision wire 8 is joined or fixed by welding or brazing.

Therefore, the above configuration has the following effects. That is, in the present embodiment, the external member 1
The bent portion 43a, 43b of the plate material 41 forming the first wire joint portion 11b, the protrusion 42 of each bent portion 43a, 43b, and the puncture portion 11a at the engaging portion of the tip bending portion 10 of the high-frequency incision wire 8 Because the direction of protrusion is restricted,
The protruding direction of the puncture portion 11a can be correctly aligned outward of the loop coaxially with the center axis of the flexible tube 2 on the loop plane formed by the high-frequency incision wire 8.
Therefore, similarly to the first embodiment, a force for pressing the external member 11 against the puncture site 23 in the patient's body can be easily applied, so that the external member 11 can be reliably punctured into the puncture site 23. Therefore, the external member 1 is disposed on the hard mucous membrane 22 or on the other side of the raised lesion 21 so as to be securely connected to the puncture site 23 which is difficult to confirm from the visual field of the endoscope.
1 can be positioned.

Further, in this embodiment, the external member 11
And the external member 1
1 is easily joined to the bent end portion 10 of the high-frequency incision wire 8.

FIGS. 8A to 8E show the fifth embodiment of the present invention.
1 shows an embodiment of the present invention. This embodiment is similar to the first embodiment (FIGS. 1A to 1D and 2A to 2 A).
The configuration of the external member 11 of the high-frequency incision and resection tool 1 (see (D)) is changed as follows. FIG. 8A
In (E) to (E), the same components as those of the first embodiment are denoted by the same reference numerals, and description thereof is omitted here.

That is, the external member 11 of the present embodiment
Is a puncturing portion constituting member 51 constituting the puncturing portion 11a,
It is formed by a combination of two members with the wire joining portion constituting member 52 constituting the wire joining portion 11b.

Here, the puncturing component 51 is shown in FIG.
(B) and a plate-like member 5 such as a modification shown in FIG.
4 may be used. In addition, a bent portion 51 a is formed at the rear end of the punctured part constituting member 51 so as to be sandwiched in the middle of the distal bent portion 10 of the high-frequency incision wire 8.

The wire connecting portion constituting member 52 is formed of a tube as shown in FIG. The inner diameter dimension D ₃ of the tubular body of the wire connecting portion constituent member 52 is set to such an extent that the bent end portion 10 of the high-frequency incision wire 8 can be housed. The notch 55 may be formed in the tube of the wire-joined part constituting member 52 as in the modification shown in FIG.

When assembling the external member 11 to the bent end portion 10 of the high-frequency incision wire 8 of the high-frequency incision and resection tool 1, the bent portion 51 a at the rear end of the puncture part constituting member 51 is bent at the front end of the high-frequency incision wire 8. In the state sandwiched in the middle of the portion 10, the bent portion 10 at the front end bent portion 10 of the high-frequency incision wire 8 and the rear end portion of the punctured partial component member 51
a is inserted into the tube of the wire connecting member 52. In this state, by caulking the outer peripheral portion of the tubular body of the wire joining portion constituting member 52, the high-frequency incision wire 8 and the external member 11 are joined and fixed.

It should be noted that the wire connecting portion constituting member 52 of the external member 11 and the bent end portion 10 of the high frequency incision wire 8
Between them may be joined or fixed by welding or brazing.

Therefore, the above configuration has the following effects. That is, in the present embodiment, the external member 1
1 is joined to the bent end portion 10 of the high-frequency incision wire 8,
The projecting direction of the puncturing portion 11a is restricted by the joint between the puncturing portion component member 51 and the bent portion 51a at the rear end of the puncturing portion component member 51, and the engaging portion of the wire joining portion component member 52 with the tubular body. Of the flexible tube 2 on the plane of the loop formed by the high-frequency incision wire 8, and can be correctly positioned outward of the loop. Therefore, similarly to the first embodiment, a force for pressing the external member 11 against the puncture site 23 in the patient's body can be easily applied, so that the external member 11 can be reliably punctured into the puncture site 23. Therefore, the external member 11 can be reliably positioned at the puncture site 23 which is arranged on the other side of the hard mucous membrane 22 or the raised lesion 21 and which is difficult to confirm from the visual field of the endoscope.

Further, in the present embodiment, the external member 11
And the external member 1
1 can be easily assembled to the bent end portion 10 of the high-frequency incision wire 8.

Note that the present invention is not limited to the above-described embodiment, and it goes without saying that various modifications can be made without departing from the spirit of the present invention. Next, other characteristic technical matters of the present application will be additionally described as follows. (Additional Item 1) A high-frequency incision wire is connected to a distal end of an operation member inserted into the flexible tube so as to be able to advance and retreat, and the high-frequency incision wire can be protruded and retracted from the distal end of the flexible tube with the operation of the operation member. In the high-frequency incision and resection tool provided in the above, a high-frequency incision wire is provided at the distal end with a high-frequency incision wire bent at the distal end, and a mounting member mounted on the high-frequency incision wire is formed by the high-frequency incision wire. A puncturing portion protruding outward in a direction coaxial with the central axis of the flexible tube, and a wire for regulating the projecting direction of the puncturing portion having a shape capable of housing a bent end portion of the high-frequency incision wire. A high-frequency incision resection tool comprising a connection part.

(Additional Item 2) The high-frequency incision and resection tool according to additional item 1, wherein the mounting member comprises two members, a member having a puncture portion and a member having a wire connection portion.

(Additional Item 3) The high-frequency incision and resection tool according to additional item 1, wherein the wire connecting portion is a tube having an inner diameter capable of housing the bent portion of the high-frequency incision wire.

(Additional Item 4) The additional item 1 is characterized in that the wire connecting portion has an inner diameter capable of housing a bent portion of a high-frequency incision wire and has a cutout in a part thereof. High frequency incision resection tool.

(Supplementary note 5) The wire connecting portion has a bifurcated shape for holding the bent end portion of the high-frequency incision wire from two directions, and a guide which can be hooked to the distal end bent portion of the high-frequency incision wire at this end. 2. The high-frequency incision and resection tool according to claim 1, comprising:

(Additional Item 6) The high-frequency incision and resection tool according to additional item 1, wherein the puncture portion is needle-shaped.

(Additional Item 7) The high-frequency incision and resection tool according to additional items 1 and 3, wherein the puncture portion is formed to be sharp by making a cutout in the tubular member and crushing the tip. .

(Additional Item 8) The high-frequency incision and resection tool according to additional items 1 and 5, wherein the mounting member is formed by bending a plate material.

(Supplementary Item 9) The high-frequency incision and resection tool according to claim 1, wherein the mounting member is formed with the configuration described in Supplementary items 6 and 2.

(Additional Item 10) The above mounting member is the additional item 6
The high-frequency incision and resection tool according to claim 1, wherein the high-frequency incision and resection tool is formed with the configuration described in claim 3.

(Additional Item 11) The mounting member is the additional item 6
The high-frequency incision and resection tool according to claim 1, wherein the high-frequency incision and resection tool is formed with the configuration described in claim 4.

(Prior Art of Additional Items 1 to 11) Additional Item 1
Prior arts for Japanese Patent Application Laid-Open No. Hei 6-20463 and Japanese Utility Model Laid-Open No. Hei 5-58111 are known.

(Problems to be Solved by Additional Items 1 to 11) JP-A-5-58111 and JP-B-6-204
No. 63 discloses that the projections or needles are joined by welding, soldering, or brazing. In this joining method, it is difficult to regulate the projection direction of the protrusion or the puncture portion of the needle. The projection direction of this projection or needle is
If it deviates from the coaxial direction with the longitudinal axis of the flexible tube on the plane of the loop formed by the high-frequency incision wire, the force for piercing the projection or the needle into the mucous membrane escapes, and the position of the high-frequency incision wire to the mucous membrane is fixed. Sometimes took a while. As a result, unnecessary pain may be given to the patient, or the physiological saline may fall out of the lesion raised by the physiological saline with the passage of time, and the treatment may not be performed. Also,
Since the force escapes to pierce the protrusion or needle into the mucous membrane and the protrusion or needle cannot be inserted into the mucous membrane to a sufficient depth, the fixed part at the tip is punctured while tightening around the lesion with a high-frequency incision wire In some cases, the high-frequency incision wire was displaced from the part, or was displaced from the mucous membrane.
As a result, unnecessary mucous membrane resection or lesion resection cannot be performed completely, which may hinder diagnosis or leave behind the lesion.

(Purpose of Additional Items 1 to 11) The projection direction of the punctured portion of the projection is formed to be coaxial with the longitudinal axis of the flexible tube on the loop surface formed by the high-frequency incision wire.

(Operation of Additional Items 1 to 11) The projection direction of the punctured portion of the projection can be easily formed coaxially with the longitudinal axis of the flexible tube on the loop plane formed by the high-frequency incision wire. .

(Effects of Supplementary Items 1 to 11) The projecting direction of the punctured portion of the projection is formed coaxially with the longitudinal axis of the flexible tube on the loop plane formed by the high-frequency incision wire. The force for pressing the projection against the puncture site is easily applied via the wire member, and the projection can be reliably punctured into the puncture site. Therefore, it is possible to reliably position the projection on a hard mucous membrane or on a puncture site that is located on the other side of the raised lesion and is difficult to confirm from the visual field of the endoscope.

(Purpose of Supplementary Items 2 to 11) An object of the present invention is to enable a projection to be easily connected to a high-frequency incision wire.

(Effects of Additional Items 2 to 11) The projection can be easily assembled to the high-frequency incision wire.

(Purpose of Supplementary Items 2, 3, 4, and 7) It is to manufacture a member to be a projection at low cost.

(Effects of Additional Items 2, 3, 4, and 7) A member serving as a projection can be manufactured at low cost.

(Purpose of Additional Items 2 to 4, 6, 7, 9, and 10) It is to make the projections rigid.

(Effects of Additional Items 2 to 4, 6, 7, 9, and 10) The rigidity of the projections can be easily secured, so that hard mucous membranes,
The projection can be reliably positioned at a puncture site that is located on the other side of the raised lesion and that is difficult to confirm from the field of view of the endoscope.

[0085]

According to the present invention, a high-frequency incision wire is provided with a distal-end bending portion at the distal end thereof, and a mounting member mounted on the distal-end bending portion is provided outside a loop formed by the high-frequency incision wire. A puncturing portion protruding in the direction coaxial with the central axis of the flexible tube; and a wire connection portion for regulating the projecting direction of the puncturing portion having a shape capable of housing the bent end portion of the high-frequency incision wire. Therefore, in assembling the high-frequency incision wire, it is possible to prevent the variation in the projecting direction of the puncture part of the puncture needle from occurring, and to perform the operation of fixing the high-frequency incision wire to the mucous membrane in a short time and efficiently, and to give the patient. Pain can be reduced.

[Brief description of the drawings]

FIG. 1 shows a first embodiment of the present invention;
(A) is a schematic configuration diagram of the entire high-frequency incision and resection tool, (B) is a longitudinal sectional view showing a treatment section of the high-frequency incision and resection tool, and (C) is a diagram showing a state before the external member of the high-frequency incision wire is connected. The perspective view of a part, (D) is a perspective view of the principal part which shows the connection state of the external member of the high frequency incision wire.

FIGS. 2A and 2B are views for explaining the operation of the high-frequency incision and resection tool according to the first embodiment, in which FIG. 2A is a perspective view showing an initial state of an operation of hooking a treatment portion on a lesion, and FIG. (C) is a perspective view showing a state in which the high-frequency incision wire is pushed out and spread around the lesion, and (D) is a perspective view showing a state in which the high-frequency incision wire is spread around the lesion. FIG.

FIG. 3 shows a first example of the high-frequency incision and resection tool according to the first embodiment.
The longitudinal section of the important section showing the modification of.

FIG. 4A is a perspective view of a main part showing a second modification of the high-frequency incision and resection tool of the first embodiment, and FIG. 4B is a perspective view of the high-frequency incision and resection tool of the first embodiment; The perspective view of the principal part which shows the modification of 3 and (C) is the perspective view of the principal part which shows the 4th modification of the high frequency incision cutting tool of 1st Embodiment.

FIG. 5 shows a second embodiment of the present invention.
(A) is a perspective view of a main part showing a state before connection of an external member of the high frequency incision wire, and (B) is a perspective view showing a connection state of the external member of the high frequency incision wire.

FIG. 6 shows a third embodiment of the present invention,
(A) is a perspective view showing a state before connection of an external member of the high-frequency incision wire, with a part of a wire joining portion being cut away;
(B) is a perspective view showing a bent state of a projection of one holding piece in an external member of the high-frequency incision wire, and (C) is a perspective view showing a connection state of the high-frequency incision wire and the external member.

FIG. 7 shows a fourth embodiment of the present invention;
(A) is a perspective view showing a state before connection of the external member of the high-frequency incision wire, and (B) is a perspective view showing connection state of the external member of the high-frequency incision wire.

FIG. 8 shows a fifth embodiment of the present invention.
(A) is a perspective view showing a connection state of an external member of the high-frequency incision wire, (B) is a perspective view showing an example of a wire joint,
(C) is a perspective view showing a modification of the wire joint, (D) is a perspective view showing an example of an external member of the high-frequency incision wire,
(E) is a perspective view which shows the modification of the external member of a high frequency incision wire.

[Explanation of symbols]

 2 Flexible tube 7 Operation wire member (operation member) 8 High-frequency incision wire 10 Tip bent portion 11 External member (mounting member) 11a Puncture portion 11b Wire connection portion

Claims (1)

[Claims] 1. A high-frequency incision wire is connected to a distal end of an operation member inserted into a flexible tube so as to be able to advance and retreat, so that the high-frequency incision wire can be protruded and retracted from the distal end of the flexible tube with operation of the operation member. In the provided high-frequency incision and resection tool, a high-frequency incision wire is provided at the distal end with a high-frequency incision wire bent at the distal end, and the high-frequency incision wire is formed on a mounting member attached to the high-frequency incision wire. A puncture portion protruding outward from the loop along the central axis of the flexible tube, and a wire connection for regulating a projection direction of the puncture portion having a shape capable of housing a bent end portion of the high-frequency incision wire. A high-frequency incision and resection tool characterized by having a part.