JPS6311935Y2 - - Google Patents

Description

[Detailed Description of the Invention] This invention relates to an intrabody cavity tissue resection device that is inserted into a body cavity and excises polyps and the like.

When removing a polyp or the like that has formed in tissue within a body cavity, such as the stomach wall, a resection device is inserted into the body cavity, that is, into the stomach, together with an endoscope, and the resection device and polyp to be removed are removed using the endoscope. I am trying to remove the polyp while observing it.

However, as shown in FIG.
Attach one end of a loop wire d for cutting having a bent part c to this slider b, and insert the other end of this loop wire d into a through hole e drilled in the slider b. It has a structure that extends to the side.

Therefore, by moving the loop wire d forward by operating the proximal side of the loop wire d, the bent portion c protrudes from the flexible tube a to form a loop as shown in FIG. 1, and this loop is inserted into the body cavity. The polyp can be burnt out by applying a high-frequency current to the loop once the loop has been tightened.

However, after removing polyps several times,
If tissue carbide adheres to the loop wire d or the loop wire d is deformed, the loop wire d
When the slider moves back and forth through the through hole e of the slider b, the resistance becomes large, and the slider b moves toward the proximal side before the loop is completely closed (the state shown in FIG. 2).
Then, when trying to close the loop further, since the length of the loop wire d from the bent part c to the slider b is different, a small loop is formed perpendicular to the longitudinal axis of the flexible tube a (see Fig. 3). state), even if you pull it any further, you will not be able to close the loop, and in the worst case, you will not be able to reopen the loop.

This idea was made based on the above circumstances, and its purpose is to close the loop when the lengths of the two wires from the bend to the slider become equal, so that the slider is at hand. The object of the present invention is to provide an intrabody cavity tissue resection device that can be moved laterally and safely and reliably remove polyps.

This invention will be explained below based on embodiments shown in the drawings. Reference numeral 1 in Fig. 4 is a flexible tube made of synthetic resin material, etc., and the tip of this tip 1a is cut diagonally to form an acute angle, and a small inner diameter is placed inside this tip 1a. A locking ring 2 is fixed. Further, the end portion 1b of the flexible tube 1 is fitted into a joint pipe 3, and this joint pipe 3
An insulating support 4 is screwed onto the outside of the holder.
The support 4 is provided with an insertion hole 5 having the same diameter as the inner diameter of the joint pipe 3, and a part of the inner circumferential surface thereof is provided with an O
Ring 6 is attached. In addition, this support 4
A side wall is provided with a mouthpiece 7 that communicates with the insertion hole 5, to which a syringe (not shown) for injecting cleaning liquid or the like can be connected.

On the other hand, a disk-shaped slider 8 is inserted into the distal end portion 1a of the flexible tube 1 so as to be movable forward and backward. A through hole 9 is formed in the slider 8 in the forward and backward directions thereof, and one end of a loop wire 10 is fixed thereto. That is, this loop wire 10 has a bent part 11 in the middle part, one end of which is fixed to the slider 8, and the other end is inserted into the through hole 9 of the slider 8 and extended toward the hand side. There is. Furthermore, a stopper 12 made of a ring that cannot be inserted through the through hole 9 is fixed to the bent portion 11 of the loop wire 10. In addition, the above-mentioned through hole 9
The loop wire 10 is inserted into the coil 13 inserted into the flexible tube 1, and constitutes an operating condition in which it reaches the proximal end of the flexible tube 1. Note that the middle portion of the loop wire 10 is fixed to the tip of the coil 13 with solder or the like. Further, the coil 13 passes through the insertion hole 5 of the support 4 and is led out to the outside, and a reinforcing pipe 15 that is slidable on the O-ring 6 of the support 4 is fitted into the coil 13. ing. Further, the end portions of the loop wire 10, coil 13, and reinforcing pipe 15 are integrally connected to a jack 16, and a cover 17 is screwed onto the jack 16. This jack 16 is connected to a high frequency generator (not shown).

Furthermore, inside the tip 1a of the flexible tube 1, a C-shaped elastic metal ring 18 as shown in FIG. has been done. However,
An elastic convex portion is formed on the inner surface of the flexible tube 1. Further, the inner diameter of the metal ring 18 is smaller than the outer diameter of the slider 8, and the metal ring 18 can be passed through the slider 8 by applying a pushing or pulling force of a certain amount or more.

When using the tissue cutter constructed in this way to remove polyps formed in a body cavity, for example, on the stomach wall, the flexible tube 1 is inserted into the stomach through the channel of the endoscope. When the coil 13 is advanced with respect to the flexible tube 1 and the support 4, the slider 8 is advanced within the flexible tube 1 via the loop wire 10. After the bent portion 11 of the loop wire 10 protrudes from the tip of the flexible tube 1 and the slider 8 comes into contact with the metal ring 18, the coil 13 is further advanced until the tip of the coil 13 and the slider 8 come into contact. ,
The slider 8 hits the metal ring 18 and is stopped as shown in FIG. 6, but the loop wire 10 slides through the through hole 9 and projects from the tip 1a of the flexible tube 1. Therefore, the bent portion 11 forms a semicircular loop. When the coil 13 is further advanced, the slider 8 pushes the metal ring 18 apart and passes through it, and moves until it comes into contact with the locking ring 2, as shown in FIG. 7, and then stops. Next, coil 1
3 is retracted, the loop wire 10 slides through the through hole 9 of the slider 8 and is drawn into the flexible tube 1, and the loop of the bent portion 11 is closed.
At this time, even if the loop wire 10 has carbide attached to the structure or is deformed, and the resistance passing through the through hole 9 increases, if the resistance to the passage of the slider 8 of the metal ring 18 is set large, the stopper can be adjusted. slider 8 until slider 12 comes into contact with slider 8.
waits against the metal ring 18 and does not move toward the hand side. That is, the lengths of both ends of the loop wire 10 from the bent portion 11 to the slider 8 are equal. Therefore, the base of the polyp is constricted by the bent portion 11 of the loop, and it can be retracted in this state. Then, a high frequency current is passed through the loop wire 10 using a high frequency generator to burn off the polyp. In this state, when the coil 13 is further retreated, the stopper 1 of the loop wire 10
2 comes into contact with the slider 8, and the bent portion 11 holding the excised polyp is drawn into the flexible tube 1 as the slider 8 retreats, completing the operation of excision of the polyp within the body cavity.

In addition, in the above embodiment, the flexible tube 1
Although a metal ring 18 is provided inside the flexible tube 1, as shown in FIG. 8, it is also possible to directly thermally deform the flexible tube 1 and provide a convex portion 19 inside the flexible tube 1, as shown in FIG. A lever 20 with the proximal side of the ring 2 extended,
20 may be provided with protrusions 21, 21. Moreover, since the coil 13 is for efficiently transmitting the force of movement from the hand to the distal end,
It may be replaced with a relatively thick wire 22 as shown in FIG.

As explained above, by providing a convex portion inside the flexible tube when the loop is drawn into the flexible tube, the slider moves after the loop is reliably closed. This has the effect that the cutting operation can be performed safely and reliably.

[Brief explanation of the drawing]

Figure 1 is a side sectional view of the tip of a conventional tissue cutter, Figures 2 and 3 are side views of the tip in use, and Figure 4 is a side sectional view showing an embodiment of this device. , FIG. 5 is a perspective view of the metal ring, FIGS. 6 and 7 are side sectional views of the tip in use, and FIGS. 8 and 9 are different embodiments of the invention. FIG. 10 is a side sectional view of a loop wire showing still another embodiment. 1... Flexible tube, 1a... Tip, 8...
Slider, 9...through hole, 10...loop wire,
DESCRIPTION OF SYMBOLS 11... Bent part, 12... Stopper, 18... Metal ring, 19... Convex part, 21... Convex part.

Claims (1)

[Scope of utility model registration request] It has a flexible tube, a slider that is movable in the flexible tube and has a through hole bored in the direction of movement, and a bent part, one end of which is attached to the slider and the other end of which is attached to the slider. Corresponds to the loop wire for resection that extends toward the proximal side through the through hole and is connected to the operating strip that can move forward and backward within the flexible tube, and the length from the bent part of the loop wire extending toward the proximal side to the slider. In the tissue resecting device, a stopper is provided at a position where the slider is moved and has an outer diameter larger than the through hole of the slider toward the distal end side of the slider. A tissue resection device for a body cavity, characterized in that a convex portion having an inner cavity smaller than the outer diameter of the slider is provided.