JPS63257547A - Treatment jig for tight binding - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial Field of Application] The present invention relates to a binding treatment tool that can guide a binding string around a binding site in a body cavity from the same direction.

[Prior Art] In recent years, endoscopy has been developed, in which an elongated insertion section is inserted into a body cavity without making an incision, and the inside of the body cavity is observed and treated using an optical system provided at the tip of the insertion section. Mirrors are widely used.

By the way, as shown in FIG. 4, when observing with the above-mentioned endoscope and tying up the wi attachment part in the body cavity 1 or the tubular parts such as fallopian tubes and vas deferens with the binding thread 2, these adhesion parts ,
The treatment instruments 3.4 such as grasping forceps are inserted into the body cavity 1 through the mantle tube 5 from both sides of the binding site 1a such as a tube, and then both treatment instruments 3.4 are operated to perform the above-mentioned procedure. After the bondage thread 2 is passed around the bondage point 1a marked F, this bondage thread 2 is
is grasped with one of the treatment instruments 3 (FIG. 4(a)).

Then, the grip of the other treatment instrument 4 on the binding thread 2 is released, the treatment instrument 3 is pulled out from the mantle tube 5, a knot is tied to the binding thread 2, and the knot is then tied to the mantle tube 5. The guide member 6 that is inserted is fed out and the binding thread 2 is pulled to bind the binding area 1a.

On the other hand, the treatment tool 4 inserted into the other cannula 5 is removed, scissors 7 are inserted into the cannula 5, the binding thread 2 is cut with the scissors 7, and the binding thread 2 is then cut at the binding area. If 1a is the m-tube portion, the scissors forceps 7 are used to cut out the bound portion 1a.

In addition, this treatment means is “ENDO3COPICINT
ERAAB DOHIN 8L 5U to GERYJ (Ku
rt 5EHH) page 26.

It is described on page 27.

[Problems to be Solved by the Invention] As described above, conventionally, when binding the binding part 1a such as the 1i22 fitting part or the tube part, at least three types of guides for the endoscope, treatment instruments 3, 4, etc. have been used. It is necessary to percutaneously insert the mantle tube 5 into the body cavity 1, and at least three puncture holes must be made in the body wall 8, which places a heavy burden on the patient.

Furthermore, since the treatment tools 3 and 4 are operated separately, the number of surgeons required is more than 2 Å, making it difficult for a second surgeon to perform the treatment quickly.

The present invention has been made in view of the above-mentioned points, and aims to provide a binding treatment tool that reduces the burden on the patient and allows a human operator to easily bind the binding site. The purpose is

[Means and effects for solving the problem] The binding treatment tool according to the present invention holds the binding thread at least at the tip of the binding thread guide body inserted through the channel, and is capable of bending and deforming when sensing temperature. A thermally deformable member is provided, and when heat is transferred to the thermally deformable member provided at least at the distal end of the binding thread guide body protruding from the distal end of the channel, the thermally deformable member is bent and deformed. The binding thread held by the thermally deformable member is guided around the binding location in the direction of the channel. Therefore, the operator μ can perform the binding treatment on the binding area from the same direction.

[Embodiments of the invention] Hereinafter, the present invention will be described in detail with reference to the drawings.

1 and 2 show a first embodiment of the present invention, and FIG. 1 (
1(a) to 1(d) are enlarged views of the main parts of the binding treatment tool showing the binding treatment over time, and FIG. 2 is an overall schematic diagram of the medical treatment tool.

The reference numeral 11 in the figure is an endoscope, and a main body part 11b is connected to the rear end of the insertion part 11a of the endoscope 11, and an eyepiece extending diagonally rearward is attached to the side surface of the main body part 11b. Part 1
1C, and an eyepiece 11d is attached to the rear end of the eyepiece 11c.

Further, the insertion section 11a is equipped with an observation optical system that guides an observation image from the tip of the insertion section 11a to the eyepiece 11d, and at least one channel is formed therein. Further, this channel communicates with an insertion opening 11e formed on the rear end surface of the main body portion 11b.

Further, reference numeral 12 denotes a mantle tube, which is inserted into the body wall 8 through a trocar (not shown) and into the body cavity 1. The insertion portion 11a of the endoscope 11 is inserted into the outer tube 12.

On the other hand, the tt tunnel member 14 is inserted into the channel through the insertion opening 11e of the endoscope v111. The rear end of this channel member 13 is bifurcated,
Treatment instrument insertion openings 13a and 13b are formed at the rear end of the treatment instrument. In addition, these agricultural implement insertion ports 13a and 13b
are converged into one within the channel member 13 and communicated toward the distal end.

In addition, one treatment instrument insertion port 1 of the channel member 13 is provided.
Grasping forceps 14, which is an example of a treatment tool, are inserted through 3a. Alligator mouth part 14 provided at the tip of this grasping forceps 14
a protrudes into the body cavity 1. Note that this alligator mouth part 14a is connected to the operating part 1 provided at the base end of the grasping forceps 14.
It is opened and closed by operating 4b.

In addition, a bondage treatment tool 1 is inserted into the other treatment tool insertion opening 13b.
A binding thread guide body 15a constituting part 5 is inserted through the binding thread guide body 15a. The binding thread guide main body 15a is formed into a strip-like shape and is made of a material having a certain degree of toughness.

Further, a thermally deformable member 15b made of a shape memory alloy or the like is integrally formed at the tip of the binding thread guide body 15a.

In the figure, the thermally deformable member 15b is brought into contact with the adhesion part 1a, which is an example of the binding part in the body cavity 1, and
The thermally deformable member 15b is bent and deformed into a figure 8 or U-shape depending on the body temperature, and a heater is attached to this heat deformable member 15b, and when necessary, a voltage is applied to this heater from an external power source, and the heat generated by this heater causes the bending deformation. Alternatively, a hot water passage may be provided in the upper two thermally deformable members 15b along the bonding thread guide body 15a, and the hot water passage may be bent and deformed by water shortage supplied to the hot water passage. Alternatively, the thermally deformable portion 4415b may be provided with a hot water tube communicating with the outside, and the hot water tube may be deformed by the flowing hot water.

Furthermore, a slit 15c for sandwiching the binding thread 2 is formed at the tip of the thermally deformable member 15b.

The binding thread 2 extends from the treatment instrument insertion port 13b along the binding thread guide body 15a.

Next, the operation of the embodiment with the above configuration will be explained.

First, the mantle 012 into which the trocar is inserted is inserted into the body wall 8 near the FI attachment part 1a via a trocar (not shown). Next, the trocar is removed, and the insertion portion 11a of the endoscope 11 is inserted into the mantle 212, and is positioned and fixed at a predetermined insertion depth.

Thereafter, the channel member 13 is inserted through the insertion opening 11e formed in the rear end surface of the main body portion 11b of the endoscope l1t11. Then, the grasping forceps 14 is passed through one of the treatment instrument insertion ports 13a which is bifurcated at the rear end of the channel member 13, and from the other treatment instrument insertion port 13b, a binding thread formed into a long and narrow band is inserted. Insert the guide body 15a. The binding thread 2 is sandwiched in a slit 15c at the tip of the thermally deformable member 15b, which is integrally formed at the tip of the binding thread guide body 15a.

Both of the treatment instrument insertion ports 13a and 13b are converged into one channel within the channel member 13, and the alligator mouth portion 14a1 of the grasping forceps 14 inserted through each of the treatment instrument insertion ports 13a and 13b, and the binding thread Guide body 15a
The thermally deformable member 15b1 integrally formed with the thermally deformable member 15b1 and the binding thread 2 hooked to the tip of the thermally deformable member 15b pass through the channel and protrude into the body cavity 1.

Then, while observing the image inside the body cavity 1 transmitted to the eyepiece 11d attached to the eyepiece 11G provided on the endoscope 11, the binding thread guide body 15 is
The thermally deformable member 15b integrally formed at the tip of the fused portion 1a is gradually brought closer to the binding portion of the adhesion portion 1a (FIG. 1(a)).

Next, the thermally deformable member 15b at the tip of the binding thread guide main body 15a is fixed as described above! i! ! The fitting part 1 is guided to the circumferential side of the binding part of the tube part (Fig. 1(b)).

When the heat deformable member 15b passes through the binding portion of the NR portion 1a by a predetermined distance, the binding thread guide body 15a
Above! 2. Lightly touch the area 1a or the body wall 8. Alternatively, if a heater is provided, turn the switch connected to the heater ON and apply voltage from an external power source to cause the heater to generate heat. Alternatively, if the thermally deformable member 15b is formed with a warm water passageway, hot water is passed through this hot water passageway, and if the thermally deformable member 15b is provided with a hot water tube, the hot water tube is Distribute hot water.

Then, the thermally deformable member 15b changes the li! due to body temperature, heater heat, hot water heat, or the like. The bondage thread 2 is deformed into an 8- or U-shape so as to wrap around the fitting tube, and the bondage thread 2 that is sandwiched at the tip is the above-mentioned l! I go around the fitting pipe part (first
Figure (C)).

Next, the alligator mouth part 14a of the gripping forceps 14 is advanced to open the slit 1 formed at the tip of the thermally deformable member 15b.
Grasp the binding thread 2 that is sandwiched between the binding threads 5c and pull it toward the hand. Then, the binding thread 2 comes off from the slit 15c, goes around the adhesion part 1a, and is made a U-turn. on the other hand,
The entire endoscope 11 is moved while being supported by the mantle tube 12, and the thermally deformable member 15b remains bent.
is evacuated from the adhesion part 1a, this thermally deformable member 1
Pull the binding thread guide main body 15a with the tip 5b provided at the tip toward the user's hand (FIG. 1(d)).

At that moment, while holding the binding thread 2, the entire channel member 13 is pulled out from the insertion opening 11e of the endoscope 1111, and the binding thread 2 is pulled out. Then, a knot is tied to the pulled out binding thread 2.

Thereafter, the gripping forceps 14 and the binding thread guide body 15a after straightening the thermally deformable member 15b are pulled out from the treatment instrument insertion ports 13a and 13b of the channel member 13.

Next, after reinserting the channel member 13 into the endoscope 11, insert forceps (not shown) into the treatment instrument insertion port 13a, while feeding the knot into the treatment instrument insertion port 13b. The guide member is inserted to feed out the knot, and the other binding thread 2 is pulled to bind the adhesion portion 1a.

Then, the binding thread 2 is cut using the clipping forceps, and the fatigue tube portion 1a is also excised.

Further, FIG. 3 is an enlarged view of a main part of a binding treatment instrument according to a second embodiment of the present invention.

The binding thread guide main body 15a of the binding treatment instrument 15 according to this embodiment is formed into a tubular shape, into which the binding thread 2 is inserted, and a thermally deformable wire of the same shape is integrally formed at the distal end portion. When the member 15b receives heat such as body temperature, it is thermally deformed into a 0-shape or a U-shape, similar to the first embodiment. Since the binding thread 2 passes through the tube and is sent into the body cavity 1, there is no difficulty in supplying it.

A3, the present invention is not limited to the above embodiments; for example, the thermally deformable member may be the entire binding thread guide body, or may be fixed to the tip of the binding thread guide body via an appropriate connecting member etc. It may be something that you have.

[Effects of the Invention] As explained above, according to the present invention, at least the tip portion of the binding thread guide body inserted into the channel is provided with a thermally deformable member that holds the binding thread and can be bent and deformed when temperature is sensed. As a result, the bondage thread can be circulated without the need for equivalent gripping means, reducing the burden on thinking and allowing a human operator to easily grasp the bondage area.
! It is possible to perform bondage treatment on I Ili.

[Brief explanation of drawings]

1 and 2 show a first embodiment of the present invention, and FIG. 1 (
Figures a) to 1(d) are enlarged views of the main parts of a binding treatment tool showing the binding treatment over time, Figure 2 is a general schematic diagram of the medical treatment tool, and Figure 3 is a second embodiment of the present invention. FIGS. 4(a) and 4(b) are enlarged views of the waist part of the example of the binding treatment tool, and are enlarged views of the main parts of the 9fi binding device showing the conventional binding treatment over time. 15... Bondage treatment tool, 15a... Bondage thread guide body, 15b... Heat deformation member. 1) (cl bc Figure 2 Figure 3 Figure 4 (a) (b)

Claims (1)

[Claims] 1. A binding treatment tool, characterized in that a thermally deformable member that holds a binding thread and is bendable and deformable when sensing temperature is provided at least at the tip of a binding thread guide body inserted through a channel.