JPS6125380B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to an improvement in a high-frequency resection tool that uses high-frequency current to ablate a target site within a body cavity.

Generally, in order to ablate tissue to be excised within a body cavity, such as a polyp site, using high-frequency current, a loop-shaped conductive wire is inserted into the body cavity, and an electrode is placed in contact with the outer surface of the human body. After engaging the loop portion of the wire with the polyp,
A high-frequency cutting tool is used to cut the polyp by passing a high-frequency current between the wire and the electrode.

By the way, as a conventional high-frequency cutting tool, the first
As shown in the figure, an operating member 2 is inserted into a flexible mantle 1.
is movably inserted, a wire 3 is provided in a loop shape at the tip thereof, and when the operating member 2 is advanced, the loop portion of the wire 3 is opened by the elasticity of the wire 3 itself. be. However, with such a configuration, there is a limit to the opening of the loop portion of the wire 3, and not only can it not be opened very widely, but also the elasticity of the wire 3 deteriorates when used repeatedly, and the degree of opening becomes even smaller. There was a drawback.

Therefore, in order to eliminate such drawbacks, the second
As shown in the figure, there is a stopper 4 on the inner surface of the tip of the mantle tube 1.
A slider 5 is slidably provided between the stopper 4 and the tip end surface of the operating member 2, and a through hole 6 is bored in the slider 5. Moreover, the wire 3 is
One end thereof is connected to the tip of the operating member 2, the middle part is inserted into the through hole 6 of the slider 5, and the other end is bent and connected to the slider 5. There is also a device in which the wire 3 is opened in a loop shape by moving the operating member 2 forward as shown by the arrow in FIG. However, according to such a configuration, although the loop portion of the wire 3 can be opened to an arbitrary size, the direction of the loop portion,
That is, even if the operating member 2 is rotated in order to change the direction of the surface formed by the loop portion of the wire 3 so that the loop portion engages with the polyp site, the slider 5 is pressed by the operating member 2 and does not come into contact with the stopper 4. Since they are in contact with each other, the slider 5 does not rotate smoothly due to frictional resistance with the stopper 4. Therefore, even if the operating member 2 is rotated, the wire 3 is only twisted, and the direction of the loop portion of the wire 3 cannot be changed in accordance with the operation of the operating member 2, resulting in extremely poor operability. It was hot.

This invention was made based on the above-mentioned circumstances, and its purpose is to provide performance that allows the loop portion of the wire to be opened sufficiently wide and to change the direction of this loop portion reliably and easily. Another object of the present invention is to provide a high-frequency cutting tool with excellent operability.

Hereinafter, one embodiment of the present invention will be described based on FIGS. 3 to 8. In the figure, reference numeral 11 denotes a hollow mantle tube made of a flexible material. A ring-shaped stopper 1 is provided on the inner surface of the tip of this mantle tube 11.
2 is provided. Further, inside the mantle tube 11, an operating member 13 and a slider 14 of a size to come into contact with the stopper 12 are slidably provided between the tip of the operating member 13 and the stopper 12. The operating member 13 is made of a material, such as a coil, that, when the rear end led out toward the user's hand is rotated, the rotation is reliably transmitted to the tip. The slider 14 also has a through hole 15.
A wire 17 having a bent portion 16 is inserted through the through hole 15 on one side thereof.
One end of this wire 17 is connected to the tip of the operating member 13, and the other end is connected to the slider 14. Furthermore, a groove 18 is formed in one end surface of the slider 14 facing the tip of the operating member 13. At the tip of the operating member 13, a protrusion 19 is provided which serves as an engaging portion and engages with the groove 18.
An engaging member 20 is provided.

Therefore, when incising polyp a in a body cavity using the above-mentioned high-frequency cutting tool, it is necessary to
With the operating member 13 retracted into the cannula 11 as shown in the figures, the cannula 11 is introduced into the body cavity through the channel of the endoscope. After this, when the operating member 13 is advanced within the mantle tube 11 as shown in FIGS. 5 and 6, this operating member 13
At the same time, the wire 17 and the slider 14 slide, and the slider 14 comes into contact with the stopper 12.
Furthermore, when the operating member 13 is advanced, the wire 1
Since only one side connected to the operating member 13 of the wire 17 slides, as shown in FIG.
As the bent portion 16 opens into a loop shape, the tip of the operating member 13 comes into contact with the slider 14, and the protrusion 19 of the engaging member 20 provided at the tip engages with the groove 18 of the slider 14. At this time, it is sufficient that the loop-shaped bent portion 16 is oriented in a direction that allows it to engage with the polyp a, but if the direction is deviated as shown in FIG. If you perform a rotation operation on the hand side, this rotation will cause the slider 1 engaged with the tip of the operation member 13 to
4, and the slider 14 can be rotated reliably. Therefore, the loop-shaped bent portion 16 of the wire 17, whose one end is connected to the operating member 13 and the other end is connected to the slider 14, is oriented as shown in FIG. It is possible to engage the polyp a in a different manner. Thereafter, although not shown, the operating member 13 is moved backward to contract the neck of the polyp a, and then the high frequency generator is activated, thereby making it possible to remove the polyp a.

Note that this invention is not limited to the above embodiment,
For example, the engagement portion provided at the tip of the operating member 13 is
As shown in FIG.
1 and facing this slope 21.
4 may also be formed into a slope 22 having the same inclination angle. According to such a configuration, the operation member 13 and the slider 14 can be smoothly engaged. FIG. 10 also shows a protruding engagement member 20 on the tip surface of the operating member 13 when the operating member 13 is made of a flexible material.
a is integrally formed, and one end surface of the slider 14 is formed with a recess 23 into which the operating member 13 fits. With this configuration, the hard part of the operating member 13 can be eliminated. Because you can
The operating member 13 can be easily slid with the mantle tube 11 bent, and the resistance when inserting the mantle tube 11 into the channel of the endoscope can be reduced.

Furthermore, if the end tube 24 is fitted to the bent portion 16 of the wire 17 as shown in FIG. mantle tube 1
1 can be reliably drawn into the interior.

Furthermore, as shown in FIG.
are two coils 25a and 25b with opposite winding directions.
With this configuration, even if the operating member 13 is rotated to the left or right, the rotation can be reliably transmitted to the slider 14. Moreover, in this case, the engaging member 2
0 is provided with a shaft portion 26 as shown in the figure, and the shaft portion 26 is fitted into the hollow portion of the operating member 13 to connect the engaging member 20 to the tip of the operating member 13.

Furthermore, although not shown, the operating member 13 may be a multi-thread coil.

In addition, in each of the other embodiments described above, the same parts as in the above-mentioned embodiment are given the same symbols, and the description thereof will be omitted.

As described above, according to the present invention, by sliding the operating member, the size of the loop formed by the bent portion of the wire, one end of which is connected to the operating member and the other end of which is connected to the slider, can be arbitrarily adjusted. Of course, since an engaging portion is provided at the tip of the operating member to transmit the rotation of the operating member to the slider, the orientation of the bent portion can be changed by rotating the operating member. It can be modified to engage target areas such as polyps. Therefore, it is possible to reliably engage and resect a polyp with the bent portion through a simple operation, which is a great practical effect.

[Brief explanation of the drawing]

FIGS. 1 and 2 are cross-sectional views showing a conventional high-frequency cutting tool, and FIGS. 3 to 8 show an embodiment of the present invention, and FIG. 3 shows a state in which the operating member is retracted. 4 is a sectional view taken along the line in FIG. 3, FIG. 5 is a sectional view showing the operating member moved forward and the bent portion of the wire is opened, and FIG. 6 is a sectional view taken along the line in FIG. 5. FIGS. 7 and 8 are explanatory diagrams showing the orientation of the bent portion of the wire relative to the polyp, and FIGS. 9 to 12 are cross-sectional views of a high-frequency cutting tool showing other embodiments of the present invention, respectively. It is a diagram. 11... Mantle tube, 12... Stoppa, 13...
Operation member, 14...Slider, 16...Bending portion, 17...Wire, 19...Protrusion (engaging portion),
20... Engaging member (engaging part), 21... Inclined surface (engaging part), 20a... engaging member (engaging part).

Claims (1)

[Claims] 1 A flexible mantle tube with a stopper provided on the inner surface of the tip, a wire having a bending part slidably provided in the mantle tube, and a wire connected to one end of the wire and connected to the other end of the wire and the mantle tube. a slider that is slidable against the stopper and comes into contact with the stopper; and an operating member connected to the other end of the wire for sliding the wire; A high-frequency cutting tool characterized in that it is provided with an engaging portion that transmits the power to the slider.