WO2014061505A1 - Treatment tool for endoscope - Google Patents

Treatment tool for endoscope Download PDF

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Publication number
WO2014061505A1
WO2014061505A1 PCT/JP2013/077345 JP2013077345W WO2014061505A1 WO 2014061505 A1 WO2014061505 A1 WO 2014061505A1 JP 2013077345 W JP2013077345 W JP 2013077345W WO 2014061505 A1 WO2014061505 A1 WO 2014061505A1
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WO
WIPO (PCT)
Prior art keywords
treatment
operation member
contact portion
endoscope
treatment tool
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Application number
PCT/JP2013/077345
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French (fr)
Japanese (ja)
Inventor
鈴木　啓太
Original Assignee
オリンパスメディカルシステムズ株式会社
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Application filed by オリンパスメディカルシステムズ株式会社 filed Critical オリンパスメディカルシステムズ株式会社
Publication of WO2014061505A1 publication Critical patent/WO2014061505A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02—Instruments for taking cell samples or for biopsy
    • A61B10/06—Biopsy forceps, e.g. with cup-shaped jaws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02—Instruments for taking cell samples or for biopsy
    • A61B10/04—Endoscopic instruments
    • A61B2010/045—Needles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00353—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery one mechanical instrument performing multiple functions, e.g. cutting and grasping
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2901—Details of shaft
    • A61B2017/2902—Details of shaft characterized by features of the actuating rod

Definitions

  • the present invention relates to an endoscope treatment tool, and more particularly, to an endoscope treatment tool including a plurality of operation members for operating a treatment portion.
  • Patent Literature 1 describes an endoscope treatment tool including a treatment unit including a pair of forceps members that are opened and closed.
  • An operation member such as an operation wire is connected to the pair of forceps members via a link mechanism.
  • the forceps member opens when the operation member is advanced toward the treatment portion, and the forceps member closes when the operation member is retracted.
  • an operation member of an endoscope treatment tool a hard rod, a flexible operation wire, or the like is known.
  • an operation wire is operated to be inserted into a forceps channel that has been bent or meandered.
  • a member Generally used as a member.
  • the operation wire is not easily deformed with respect to the pulling operation and can transmit the force appropriately to the treatment section.
  • the operation wire may not be able to transmit force appropriately to the treatment section depending on the pushing operation for moving forward. Therefore, for example, in a state where a large amount of tissue exists around the treatment portion, the force cannot be sufficiently transmitted. As a result, it is not easy or impossible to open the pair of forceps members against the tissue, and a desired treatment may be difficult.
  • the present invention has been made in view of such a problem, and can easily transmit the amount of operation force to the treatment section when the operation member is moved forward or backward, thereby facilitating operation.
  • An object of the present invention is to provide an endoscopic treatment tool.
  • An endoscope treatment tool is a treatment for performing a predetermined treatment in a living body, which is attached to a flexible long insertion portion and a distal end portion of the insertion portion.
  • a first operating member that is connected to the treatment section and moves the treatment section by moving backward with respect to the insertion section; and the treatment section having higher compression resistance than the first operation member
  • a second operation member that is connected to the insertion portion and moves the treatment portion by moving forward with respect to the insertion portion; and is attached to a proximal end portion of the insertion portion and operates the first operation member and the second operation member
  • the operation portion includes a first contact portion that contacts the first operation member, and the second operation member. And a second abutting portion that abuts.
  • the first contact portion and the second contact portion may be provided on the same slider.
  • the first contact portion and the second contact portion are configured such that when the first contact portion contacts the first operation member, the second operation member and the second contact portion are not in contact with each other.
  • the first operation member and the first contact portion are in a non-contact state. Thus, only the second operation member may be operated.
  • the second operation member may be an operation coil made of a metal strand.
  • the first operation member may be inserted through the operation coil.
  • the endoscope treatment tool can easily transmit the operation force amount to the treatment portion both when the operation member is moved forward and when the operation member is moved backward. Can be provided.
  • FIG. 1 is a diagram showing an overall configuration of an endoscope treatment tool according to a first embodiment of the present invention. It is a figure which shows the treatment part and its periphery of the treatment tool for endoscopes which concern on 1st embodiment of this invention in a partial cross section. It is sectional drawing which shows the operation part in the treatment tool for endoscopes which concerns on 2nd embodiment of this invention. It is a figure which shows the other example of the treatment part in the treatment tool for endoscopes which concerns on 1st embodiment of this invention. It is a figure which shows 1 operation
  • FIG. 1 is a diagram illustrating an overall configuration of an endoscope treatment tool 1 according to the present embodiment.
  • the biopsy needle (endoscopic treatment tool) 1 includes a long flexible insertion portion 10, a treatment portion 20, and an operation portion 50.
  • the treatment portion 20 is provided at the distal end portion of the insertion portion 10.
  • the operation unit 50 is attached to the proximal end portion of the needle tube 10.
  • the insertion portion 10 is formed in a flexible tubular shape having a lumen, and a coil, a resin, or the like can be used as a material.
  • FIG. 2 is a diagram showing a partial cross section of the treatment section 20 and its periphery.
  • the treatment portion 20 includes a pair of forceps members 21 that can be opened and closed, and a cover member 22.
  • a forceps member 21 is attached to the cover member 22.
  • the pair of forceps members 21 are rotatably attached to a rotation shaft 23 fixed to the cover member 22.
  • the cover member 22 is fixed to the distal end portion of the insertion portion 10.
  • the operating member 30 for operating the treatment section is inserted into the inner cavity of the insertion section 10 so as to be able to advance and retreat with respect to the insertion section 10.
  • the operation member 30 includes an operation wire 31 (first operation member), an operation coil 32 (second operation member), and a connection member 33.
  • An operation wire 31 is inserted through the operation coil 32.
  • the distal ends of the operation wire 31 and the operation coil 32 are fixed to the connection member 33.
  • the operation wire 31 is a known wire formed by stranding a strand made of metal or the like, or a single wire.
  • the operation wire 31 is equivalent to a wire used for operating a treatment portion in a general endoscope treatment tool.
  • the operation coil 32 has a known configuration in which metal strands are closely wound in a spiral shape, and has an inner diameter larger than the outer diameter of the operation wire 31.
  • the connecting member 33 is made of metal or the like.
  • the connection member 33 has a cylindrical fixing portion 33A on the proximal end side.
  • the distal end portion of the operation wire 31 is fixed to the connection member 33 by bonding, soldering, brazing, or the like while being inserted into the lumen of the fixing portion 33A.
  • the operation coil 32 and the fixing portion 33A are integrally formed by joining the inner surface of the operation coil 32 and the outer peripheral surface of the fixing portion 33A in a state where the fixing portion 33A is inserted into the lumen of the distal end portion of the operation coil 32. It is fixed.
  • the operation coil 32 and the fixing portion 33A are joined by means such as adhesion, soldering, or brazing.
  • connection member 33 and the proximal end side of the pair of forceps members 21 are connected via a link member 34. Accordingly, when the operation member 30 is advanced and retracted with respect to the insertion portion 10, the pair of forceps members 21 rotate around the rotation shaft 23, and the treatment portion 20 functions as a forceps that can be opened and closed.
  • the operation unit 50 includes an operation unit main body 51 and a slider 52, and the basic configuration thereof is known.
  • the operation portion main body 51 is fixed to the proximal end portion of the insertion portion 10.
  • the slider 52 is attached to be slidable in the longitudinal direction of the operation section main body 51.
  • the operation wire 31 extending through the insertion portion 10 and the proximal end portion of the operation coil 32 protrude into the internal space of the operation portion main body 51 and are fixed to the slider 52. Therefore, the operation member 30 can be moved forward and backward with respect to the insertion portion 10 by sliding the slider 52 with respect to the operation portion main body 51.
  • the user first introduces an endoscope (not shown) into the patient's body and moves the distal end portion of the endoscope to the vicinity of the target tissue to be treated.
  • the user inserts the endoscope treatment tool 1 into the forceps channel of the endoscope from the treatment portion 20 side, and causes the treatment portion 20 to protrude from the distal end opening of the forceps channel.
  • the user opens the pair of forceps members 21 by moving the slider 52 of the operation unit 50 forward while confirming the target tissue in the visual field of the endoscope.
  • the user arranges the pair of forceps members 21 such that a part of the target tissue is positioned between the pair of forceps members 21.
  • the pair of forceps members 21 are closed and the target tissue is grasped.
  • the operation coil 32 having more excellent compression resistance among the operation members 30 mainly transmits the operation force amount to the treatment section 20.
  • the operation wire 31 having higher tensile resistance mainly transmits the operation force amount to the treatment section 20.
  • the operation member 30 that transmits the operation force amount to the treatment unit 20 is operated in addition to the operation wire 31 that is generally used in a flexible endoscope treatment tool.
  • An operation coil 32 having higher compression resistance than the wire 31 is provided. For this reason, it is possible to suitably transmit the amount of operation force to the treatment unit 20 both when the operation member 30 is moved forward and when the operation member 30 is moved backward, and an endoscope treatment tool that can be easily operated can be provided. .
  • FIG. 3 is a cross-sectional view showing the operation unit 70 of the endoscope treatment tool 61 according to the present embodiment. Similar to the first embodiment, the operation unit 70 includes an operation unit main body 71 and a slider 72. However, the operation wire 31 extending through the insertion portion 10 and the proximal end portion of the operation coil 32 are not fixed to the slider 72.
  • the proximal end portion 32A of the operation coil 32 is located on the distal end side with respect to the slider 72.
  • the operation coil 32 can be advanced while the end surface (second contact portion) 72A on the distal end side of the slider 72 is in contact with the base end portion 32A of the operation coil 32.
  • the operation wire 31 extends through the through hole 73 formed in the slider 72 to the proximal end side than the slider 72.
  • a disc-shaped diameter-expanding member 74 is attached to the proximal end portion 31 ⁇ / b> A of the operation wire 31.
  • the diameter of the base end portion 31 ⁇ / b> A of the operation wire 31 is enlarged, and the diameter-expanding member 74 cannot enter the through hole 73. Therefore, when the slider 72 is retracted, the end surface (first contact portion) 72B on the base end side of the slider 72 can be brought into contact with the diameter-expanding member 74 of the operation wire 31 and the operation wire 31 can be pulled.
  • the amount of operation force is suitably treated both when the operation member is advanced and when the operation member is moved backward. Can be transmitted to the part.
  • the slider 72 when the slider 72 is retracted, the slider 72 and the operation coil 32 are not in contact with each other, and only the operation wire 31 is pulled.
  • the slider 71 moves forward, the slider 72 and the operation wire 31 are not in contact with each other, and only the operation coil 32 is pressed. That is, when pulling and pressing the operation member, the slider 72 contacts only a member capable of suitably transmitting the force in each operation. As a result, there is no loss of force transmission due to contact with the other operation member, and the operation force can be more suitably transmitted to the treatment section.
  • the configuration of the treatment section is not limited to the above-described forceps.
  • other examples of the treatment unit will be described.
  • the treatment section 80 shown in FIG. 4 is a biopsy needle provided with a puncture section 81 and a collection member 82.
  • the puncture portion 81 is sharply formed at the tip and is punctured into the tissue.
  • the sampling member 82 is rotatably attached to the puncture portion 81.
  • the distal end side of the collection member 82 is formed in a cup shape so as to accommodate the tissue, and the proximal end portion 82 ⁇ / b> A of the collection member 82 is connected to the operation member 30 via the link 83.
  • the treatment section 80 is inserted into the channel when housed in the outer sheath 85 (insertion section) in order to prevent the puncture section 81 from damaging the channel inner wall of the endoscope, and the outer sheath 85 is used when performing a biopsy. Protruding from.
  • the puncture unit 81 is punctured into an organ or the like from which a tissue is collected. Thereafter, when the operation member 30 is advanced, the sampling member 82 rotates around the rotation shaft 84 and protrudes from the outer peripheral surface of the puncture portion 81 as shown in FIG. When the operating member 30 is retracted in this state, a part of the tissue is scraped off from the organ or the like by the sampling member 82 and is stored in the cup-shaped space on the distal end side, and the sampling member 82 is stored in the puncture portion 81. Is done.
  • the operation of causing the sampling member 82 to protrude from the outer peripheral surface of the puncture unit 81 requires a large amount of force because a large amount of tissue exists around the puncture unit 81 punctured into an organ or the like.
  • the operation member 30 includes the operation coil 32 having excellent compression resistance, the amount of operation force for advancing the operation member is suitably transmitted to the treatment section, and the tissue sampling procedure can be suitably performed. .
  • the treatment unit 90 shown in FIG. 6 is also a biopsy needle provided with a puncture unit and a collection member, similar to the treatment unit 80 described above. It is comprised so that it may protrude from the outer peripheral surface of 81. FIG.
  • the connection mode between the operation member and the sampling member the correspondence between the advance / retreat of the operation member and the operation of the sampling member can be set as appropriate.
  • the treatment section 100 shown in FIG. 7 is configured as a so-called known umbrella-shaped biopsy instrument including an inner blade portion 101 provided with a puncture portion 101A and an outer blade portion 105 through which the inner blade portion 101 is inserted.
  • the inner blade portion 101 has a sharp puncture portion 101A on the distal end side, and has an inner blade 102 on the proximal end side with respect to the puncture portion 101A.
  • the inner blade 102 is formed in a circumferential shape centered on the axis of the puncture needle 101A and has an inner blade 102 facing the proximal end side.
  • the outer blade portion 105 is attached to the distal end portion of the coil sheath 110 through which the operation member 30 is inserted, and has an outer blade 106.
  • the outer blade 106 is formed in a circumferential shape that is substantially concentric with the inner blade 102 and has a larger diameter than the inner blade 102, and faces the distal end side.
  • the base end portion 101 ⁇ / b> B of the inner blade portion 101 is connected to the operation member 30, and can advance and retreat with respect to the outer blade portion 105.
  • the shape of the base end portion 101B is the same as that of the connecting member 33, but the shape of the base end portion is not particularly limited.
  • the operation member 30 has the operation coil 32 having excellent compression resistance. Therefore, the amount of operating force for moving the operating member forward can be suitably transmitted to the inner blade portion 101 against the above-described pushing force. As a result, it is possible to suitably perform breakthrough of a stenosis site where a relatively large amount of force is required.
  • the treatment section 110 shown in FIG. 8 is a so-called known guillotine-type biopsy needle including a needle tube 111 having a puncture portion 111A and a separation portion 112 accommodated in the needle tube 111.
  • a collection hole 113 for collecting a tissue is provided on the side surface of the needle tube 111.
  • the separation part 112 has a cutting blade 114 facing the proximal end side, and is connected to the operation member 30.
  • the separation part in order to cut out the tissue appropriately, the separation part may be advanced and retracted several times. At this time, if the tissue protrudes into the lumen of the needle tube, it may become an obstacle when the separation portion is advanced.
  • the operation force amount is suitably transmitted to the separation unit 112 by the operation member 30 including the operation coil 32, and the separation unit 112. The forward operation can be suitably performed.
  • the operation member in the present embodiment can suitably transmit both the forward and backward operation force amounts to the treatment section. For this reason, it is particularly suitable when combined with a treatment section that requires a relatively large force for forward operation. Therefore, it is natural that the configuration of the treatment portion in the endoscope treatment tool according to the present invention is not limited to the above-described forceps, various biopsy needles, and biopsy tools.
  • the operation wire that is the first operation member is inserted into the operation coil that is the second operation member.
  • the arrangement mode of the first operation member and the second operation member is not limited to this, and for example, the first operation member and the second operation member may be arranged so as to run in parallel. In this case, since it is not necessary to secure a space for passing the operation wire through the lumen of the operation coil, the inner diameter of the operation coil can be reduced.
  • the first operating member and the second operating member do not necessarily have to be operated with a common slider.
  • the first operating member and the second operating member may be attached to separate sliders and may be operated independently.
  • the connection member is not essential for the operation member in the present embodiment. Therefore, the first operation member and the second operation member may be directly connected to the treatment section.
  • the endoscope treatment tool can easily transmit the operation force amount to the treatment portion both when the operation member is moved forward and when the operation member is moved backward. Can be provided.

Abstract

This treatment tool for an endoscope comprises: a long flexible insertion portion; a treatment portion that is attached to a distal end of the insertion portion; a first operation member that is connected to the treatment portion and operates the treatment portion by moving backward with respect to the insertion portion; a second operation member that is connected to the treatment portion with a higher compression resistance than the first operation member and operates the treatment portion by moving forward with respect to the insertion portion; and an operation portion that is attached to a base end of the insertion portion and which is for operating the first operation member and the second operation member.

Description

内視鏡用処置具Endoscopic treatment tool
　本発明は、内視鏡用処置具、より詳しくは、処置部を動作させるための操作部材を複数備えた内視鏡用処置具に関する。本願は、２０１２年１０月１８日に、米国に仮出願された米国仮出願６１／７１５５３９号に基づき優先権を主張し、その内容をここに援用する。 The present invention relates to an endoscope treatment tool, and more particularly, to an endoscope treatment tool including a plurality of operation members for operating a treatment portion. This application claims priority based on US Provisional Application No. 61/715539 filed provisionally in the United States on October 18, 2012, the contents of which are incorporated herein by reference.
　従来、体内組織に対して処置を行うための処置部を、可撓性を有する長尺の挿入部の先端部に備えた、いわゆる軟性の内視鏡用処置具が知られている。例えば、特許文献１には、開閉する一対の鉗子部材を処置部に備えた内視鏡用処置具が記載されている。一対の鉗子部材には、リンク機構を介して操作ワイヤ等の操作部材が接続されている。この内視鏡用処置具は、操作部材を処置部に向かって前進させると鉗子部材が開き、後退させると鉗子部材が閉じる。 2. Description of the Related Art Conventionally, a so-called flexible endoscopic treatment tool has been known in which a treatment portion for treating a body tissue is provided at the distal end portion of a flexible long insertion portion. For example, Patent Literature 1 describes an endoscope treatment tool including a treatment unit including a pair of forceps members that are opened and closed. An operation member such as an operation wire is connected to the pair of forceps members via a link mechanism. In this endoscopic treatment tool, the forceps member opens when the operation member is advanced toward the treatment portion, and the forceps member closes when the operation member is retracted.
　内視鏡用処置具の操作部材としては、硬質のロッドや可撓性を有する操作ワイヤ等が知られている。特に、挿入部が可撓性を有する軟性の内視鏡に挿通して使用する軟性の内視鏡用処置具においては、湾曲や蛇行等を生じた鉗子チャンネルに挿通するために操作ワイヤを操作部材として用いるのが一般的である。 As an operation member of an endoscope treatment tool, a hard rod, a flexible operation wire, or the like is known. In particular, in a flexible endoscope treatment instrument that is used by inserting an insertion portion through a flexible flexible endoscope, an operation wire is operated to be inserted into a forceps channel that has been bent or meandered. Generally used as a member.
日本国特開平９－２９９３７８号公報Japanese Laid-Open Patent Publication No. 9-299378
　操作ワイヤは、引張り操作に対しては変形しにくく、処置部に好適に力量を伝達できる。その反面、操作ワイヤは、前進させるための押し込み操作によっては、処置部に好適に力量を伝達できない場合がある。そのため、例えば処置部の周囲に多量の組織が存在する状態では、力量を充分に伝達できない。その結果、一対の鉗子部材を組織に抗して開くことが容易でない、あるいは不能となり、所望の処置が困難となる場合がある。 ¡The operation wire is not easily deformed with respect to the pulling operation and can transmit the force appropriately to the treatment section. On the other hand, the operation wire may not be able to transmit force appropriately to the treatment section depending on the pushing operation for moving forward. Therefore, for example, in a state where a large amount of tissue exists around the treatment portion, the force cannot be sufficiently transmitted. As a result, it is not easy or impossible to open the pair of forceps members against the tissue, and a desired treatment may be difficult.
　本発明は、このような課題に鑑みてなされたものであって、操作部材を前進させるとき、および後退させるときのいずれにおいても操作力量を好適に処置部に伝達することができ、操作の容易な内視鏡用処置具を提供することを目的とする。 The present invention has been made in view of such a problem, and can easily transmit the amount of operation force to the treatment section when the operation member is moved forward or backward, thereby facilitating operation. An object of the present invention is to provide an endoscopic treatment tool.
　本発明の第一の態様に係る内視鏡用処置具は、可撓性を有する長尺の挿入部と、前記挿入部の先端部に取り付けられ、生体内で所定の処置を行うための処置部と、前記処置部に接続され、前記挿入部に対して後退することで前記処置部を動作させる第一操作部材と、前記第一操作部材よりも高い耐圧縮性を有して前記処置部に接続され、前記挿入部に対して前進することで前記処置部を動作させる第二操作部材と、前記挿入部の基端部に取り付けられ、前記第一操作部材および前記第二操作部材を操作するための操作部とを備える。 An endoscope treatment tool according to a first aspect of the present invention is a treatment for performing a predetermined treatment in a living body, which is attached to a flexible long insertion portion and a distal end portion of the insertion portion. A first operating member that is connected to the treatment section and moves the treatment section by moving backward with respect to the insertion section; and the treatment section having higher compression resistance than the first operation member A second operation member that is connected to the insertion portion and moves the treatment portion by moving forward with respect to the insertion portion; and is attached to a proximal end portion of the insertion portion and operates the first operation member and the second operation member An operation unit for performing the operation.
　本発明の第二の態様によれば、第一の態様に係る内視鏡用処置具において、前記操作部は、前記第一操作部材と当接する第一当接部と、前記第二操作部材と当接する第二当接部と、を有してもよい。 According to the second aspect of the present invention, in the endoscope treatment tool according to the first aspect, the operation portion includes a first contact portion that contacts the first operation member, and the second operation member. And a second abutting portion that abuts.
　本発明の第三の態様によれば、第二の態様に係る内視鏡用処置具において、前記第一当接部および前記第二当接部は、同一のスライダに設けられていてもよい。前記第一当接部および前記第二当接部は、前記第一当接部が前記第一操作部材と当接するときは、前記第二操作部材と前記第二当接部とが非接触の状態となって前記第一操作部材だけが操作され、前記第二当接部が前記第二操作部材と当接するときは、前記第一操作部材と前記第一接部とが非接触の状態となって前記第二操作部材だけが操作されるように設けられてもよい。 According to the third aspect of the present invention, in the endoscope treatment tool according to the second aspect, the first contact portion and the second contact portion may be provided on the same slider. . The first contact portion and the second contact portion are configured such that when the first contact portion contacts the first operation member, the second operation member and the second contact portion are not in contact with each other. When only the first operation member is operated and the second contact portion comes into contact with the second operation member, the first operation member and the first contact portion are in a non-contact state. Thus, only the second operation member may be operated.
　本発明の第四の態様によれば、第一の態様に係る内視鏡用処置具では、前記第二操作部材は、金属素線からなる操作コイルであってもよい。前記第一操作部材は、前記操作コイルに挿通されていてもよい。 According to the fourth aspect of the present invention, in the endoscope treatment tool according to the first aspect, the second operation member may be an operation coil made of a metal strand. The first operation member may be inserted through the operation coil.
　上記内視鏡用処置具によれば、操作部材を前進させるとき、および後退させるときのいずれにおいても操作力量を好適に処置部に伝達することができ、操作の容易な内視鏡用処置具を提供することができる。 According to the endoscope treatment tool, the endoscope treatment tool can easily transmit the operation force amount to the treatment portion both when the operation member is moved forward and when the operation member is moved backward. Can be provided.
本発明の第一実施形態に係る内視鏡用処置具の全体構成を示す図である。1 is a diagram showing an overall configuration of an endoscope treatment tool according to a first embodiment of the present invention. 本発明の第一実施形態に係る内視鏡用処置具の処置部およびその周辺を一部断面で示す図である。It is a figure which shows the treatment part and its periphery of the treatment tool for endoscopes which concern on 1st embodiment of this invention in a partial cross section. 本発明の第二実施形態に係る内視鏡用処置具における操作部を示す断面図である。It is sectional drawing which shows the operation part in the treatment tool for endoscopes which concerns on 2nd embodiment of this invention. 本発明の第一実施形態に係る内視鏡用処置具における処置部の他の例を示す図である。It is a figure which shows the other example of the treatment part in the treatment tool for endoscopes which concerns on 1st embodiment of this invention. 図４に示す処置部の使用時の一動作を示す図である。It is a figure which shows 1 operation | movement at the time of use of the treatment part shown in FIG. 本発明に係る内視鏡用処置具の処置部の他の例を示す図である。It is a figure which shows the other example of the treatment part of the treatment tool for endoscopes which concerns on this invention. 本発明に係る内視鏡用処置具の処置部の他の例を示す図である。It is a figure which shows the other example of the treatment part of the treatment tool for endoscopes which concerns on this invention. 本発明に係る内視鏡用処置具の処置部の他の例を示す図である。It is a figure which shows the other example of the treatment part of the treatment tool for endoscopes which concerns on this invention.
　本発明の第一実施形態について、図１および図２を参照して説明する。
　図１は、本実施形態に係る内視鏡用処置具１の全体構成を示す図である。生検針（内視鏡用処置具）１は、可撓性を有する長尺の挿入部１０と、処置部２０と、操作部５０とを備えている。処置部２０は、挿入部１０の先端部に設けられている。操作部５０は、針管１０の基端部に取り付けられている。挿入部１０は、内腔を有する可撓管状に形成されており、コイルや樹脂等を材料として用いることができる。 A first embodiment of the present invention will be described with reference to FIGS. 1 and 2.
FIG. 1 is a diagram illustrating an overall configuration of an endoscope treatment tool 1 according to the present embodiment. The biopsy needle (endoscopic treatment tool) 1 includes a long flexible insertion portion 10, a treatment portion 20, and an operation portion 50. The treatment portion 20 is provided at the distal end portion of the insertion portion 10. The operation unit 50 is attached to the proximal end portion of the needle tube 10. The insertion portion 10 is formed in a flexible tubular shape having a lumen, and a coil, a resin, or the like can be used as a material.
　図２は、処置部２０およびその周辺を一部断面で示す図である。処置部２０は、図１および図２に示すように、開閉可能な一対の鉗子部材２１と、カバー部材２２とを備えている。カバー部材２２には、鉗子部材２１が取り付けられている。一対の鉗子部材２１は、カバー部材２２に固定された回動軸２３に、回転可能に取り付けられている。カバー部材２２は、挿入部１０の先端部に固定されている。 FIG. 2 is a diagram showing a partial cross section of the treatment section 20 and its periphery. As shown in FIGS. 1 and 2, the treatment portion 20 includes a pair of forceps members 21 that can be opened and closed, and a cover member 22. A forceps member 21 is attached to the cover member 22. The pair of forceps members 21 are rotatably attached to a rotation shaft 23 fixed to the cover member 22. The cover member 22 is fixed to the distal end portion of the insertion portion 10.
　挿入部１０の内腔には、処置部を動作させるための操作部材３０が、挿入部１０に対して進退可能に挿通されている。操作部材３０は、操作ワイヤ３１（第一操作部材）と、操作コイル３２（第二操作部材）と、接続部材３３とを備えている。操作コイル３２には、操作ワイヤ３１が挿通されている。接続部材３３には、操作ワイヤ３１および操作コイル３２の先端部が固定されている。 The operating member 30 for operating the treatment section is inserted into the inner cavity of the insertion section 10 so as to be able to advance and retreat with respect to the insertion section 10. The operation member 30 includes an operation wire 31 (first operation member), an operation coil 32 (second operation member), and a connection member 33. An operation wire 31 is inserted through the operation coil 32. The distal ends of the operation wire 31 and the operation coil 32 are fixed to the connection member 33.
　操作ワイヤ３１は、金属等からなる素線を、単線または撚り合わせて形成された公知のワイヤである。操作ワイヤ３１は、一般的な内視鏡処置具において処置部を操作するために用いられているワイヤと同等である。操作コイル３２は、金属素線が螺旋状に密巻きされた公知の構成を有し、操作ワイヤ３１の外径よりも大きい内径を有する。 The operation wire 31 is a known wire formed by stranding a strand made of metal or the like, or a single wire. The operation wire 31 is equivalent to a wire used for operating a treatment portion in a general endoscope treatment tool. The operation coil 32 has a known configuration in which metal strands are closely wound in a spiral shape, and has an inner diameter larger than the outer diameter of the operation wire 31.
　接続部材３３は、金属等で形成されている。接続部材３３は、基端側に円筒状の固定部３３Ａを有する。操作ワイヤ３１の先端部は、固定部３３Ａの内腔に挿入された状態で、接着やはんだ付け、あるいはロウ付け等により接続部材３３に固定されている。操作コイル３２と固定部３３Ａとは、固定部３３Ａが操作コイル３２先端部の内腔に挿入された状態で、操作コイル３２の内面と固定部３３Ａの外周面とが接合されることにより一体に固定されている。操作コイル３２と固定部３３Ａとは、接着やはんだ付け、あるいはロウ付け等の手段で接合されている。 The connecting member 33 is made of metal or the like. The connection member 33 has a cylindrical fixing portion 33A on the proximal end side. The distal end portion of the operation wire 31 is fixed to the connection member 33 by bonding, soldering, brazing, or the like while being inserted into the lumen of the fixing portion 33A. The operation coil 32 and the fixing portion 33A are integrally formed by joining the inner surface of the operation coil 32 and the outer peripheral surface of the fixing portion 33A in a state where the fixing portion 33A is inserted into the lumen of the distal end portion of the operation coil 32. It is fixed. The operation coil 32 and the fixing portion 33A are joined by means such as adhesion, soldering, or brazing.
　接続部材３３の先端側と、一対の鉗子部材２１の基端側とは、リンク部材３４を介して接続されている。これにより、操作部材３０を挿入部１０に対して進退させると、一対の鉗子部材２１が回動軸２３を中心にして回動し、処置部２０が開閉可能な鉗子として機能する。 The distal end side of the connection member 33 and the proximal end side of the pair of forceps members 21 are connected via a link member 34. Accordingly, when the operation member 30 is advanced and retracted with respect to the insertion portion 10, the pair of forceps members 21 rotate around the rotation shaft 23, and the treatment portion 20 functions as a forceps that can be opened and closed.
　操作部５０は、図１に示すように、操作部本体５１と、スライダ５２とを備えており、その基本構成は公知である。操作部本体５１は、挿入部１０の基端部に固定されている。スライダ５２は、操作部本体５１の長手方向に摺動可能に取り付けられている。挿入部１０内を通って延びた操作ワイヤ３１および操作コイル３２の基端部は、操作部本体５１の内部空間に突出し、スライダ５２に固定されている。したがって、スライダ５２を操作部本体５１に対して摺動させることで、操作部材３０を挿入部１０に対して進退させることができる。 As shown in FIG. 1, the operation unit 50 includes an operation unit main body 51 and a slider 52, and the basic configuration thereof is known. The operation portion main body 51 is fixed to the proximal end portion of the insertion portion 10. The slider 52 is attached to be slidable in the longitudinal direction of the operation section main body 51. The operation wire 31 extending through the insertion portion 10 and the proximal end portion of the operation coil 32 protrude into the internal space of the operation portion main body 51 and are fixed to the slider 52. Therefore, the operation member 30 can be moved forward and backward with respect to the insertion portion 10 by sliding the slider 52 with respect to the operation portion main body 51.
　上記のように構成された本実施形態に係る内視鏡用処置具１の使用時の動作について説明する。
　使用者は、まず図示しない内視鏡を患者の体内に導入し、処置を行う対象組織の付近まで内視鏡の先端部を移動させる。次に、使用者は、内視鏡用処置具１を処置部２０側から内視鏡の鉗子チャンネルに挿入し、鉗子チャンネルの先端開口から処置部２０を突出させる。 An operation at the time of use of the endoscope treatment tool 1 according to the present embodiment configured as described above will be described.
The user first introduces an endoscope (not shown) into the patient's body and moves the distal end portion of the endoscope to the vicinity of the target tissue to be treated. Next, the user inserts the endoscope treatment tool 1 into the forceps channel of the endoscope from the treatment portion 20 side, and causes the treatment portion 20 to protrude from the distal end opening of the forceps channel.
　使用者は、内視鏡の視野で対象組織を確認しながら、操作部５０のスライダ５２を前進させて一対の鉗子部材２１を開く。使用者は、一対の鉗子部材２１間に対象組織の一部が位置するように一対の鉗子部材２１を配置する。この状態で使用者がスライダ５２を後退させると一対の鉗子部材２１が閉じ、対象組織が把持される。 The user opens the pair of forceps members 21 by moving the slider 52 of the operation unit 50 forward while confirming the target tissue in the visual field of the endoscope. The user arranges the pair of forceps members 21 such that a part of the target tissue is positioned between the pair of forceps members 21. When the user retreats the slider 52 in this state, the pair of forceps members 21 are closed and the target tissue is grasped.
　上述の操作において、スライダ５２を前進させるときには、操作部材３０のうち、より耐圧縮性に優れた操作コイル３２が主に処置部２０に操作力量を伝達する。スライダ５２を後退させるときには、より耐引張り性に優れた操作ワイヤ３１が主に処置部２０に操作力量を伝達する。これにより、スライダ５２を前進させるとき、後退させるときのいずれにおいても、操作力量が好適に処置部２０に伝達され、一対の鉗子部材２１の開閉が、確実かつスムーズに行われる。 In the above-described operation, when the slider 52 is moved forward, the operation coil 32 having more excellent compression resistance among the operation members 30 mainly transmits the operation force amount to the treatment section 20. When the slider 52 is retracted, the operation wire 31 having higher tensile resistance mainly transmits the operation force amount to the treatment section 20. Thereby, both when the slider 52 is moved forward and when the slider 52 is moved backward, the amount of operating force is suitably transmitted to the treatment section 20, and the pair of forceps members 21 are opened and closed reliably and smoothly.
　本実施形態に係る内視鏡用処置具１によれば、処置部２０に操作力量を伝達する操作部材３０が、軟性の内視鏡用処置具において一般的な操作ワイヤ３１に加えて、操作ワイヤ３１よりも高い耐圧縮性を有する操作コイル３２を有している。このため、操作部材３０を前進させるとき、および後退させるときのいずれにおいても操作力量を好適に処置部２０に伝達することができ、操作の容易な内視鏡用処置具を提供することができる。 According to the endoscope treatment tool 1 according to the present embodiment, the operation member 30 that transmits the operation force amount to the treatment unit 20 is operated in addition to the operation wire 31 that is generally used in a flexible endoscope treatment tool. An operation coil 32 having higher compression resistance than the wire 31 is provided. For this reason, it is possible to suitably transmit the amount of operation force to the treatment unit 20 both when the operation member 30 is moved forward and when the operation member 30 is moved backward, and an endoscope treatment tool that can be easily operated can be provided. .
　次に、本発明の第二実施形態について、図３を参照して説明する。本実施形態の内視鏡用処置具６１と第一実施形態の内視鏡用処置具１との異なるところは、操作部材の操作部に対する接続態様である。以降の説明において、すでに説明したものと共通する構成については、同一の符号を付して重複する説明を省略する。 Next, a second embodiment of the present invention will be described with reference to FIG. The difference between the endoscope treatment tool 61 of the present embodiment and the endoscope treatment tool 1 of the first embodiment is the connection mode of the operation member to the operation portion. In the following description, components that are the same as those already described are assigned the same reference numerals, and redundant descriptions are omitted.
　図３は、本実施形態に係る内視鏡用処置具６１の操作部７０を示す断面図である。操作部７０は、第一実施形態同様、操作部本体７１およびスライダ７２を備えている。しかし、挿入部１０内を通って延びた操作ワイヤ３１および操作コイル３２の基端部は、スライダ７２に対して固定されていない。 FIG. 3 is a cross-sectional view showing the operation unit 70 of the endoscope treatment tool 61 according to the present embodiment. Similar to the first embodiment, the operation unit 70 includes an operation unit main body 71 and a slider 72. However, the operation wire 31 extending through the insertion portion 10 and the proximal end portion of the operation coil 32 are not fixed to the slider 72.
　操作コイル３２の基端部３２Ａは、スライダ７２よりも先端側に位置する。スライダ７２を前進させることにより、スライダ７２の先端側の端面（第二当接部）７２Ａを操作コイル３２の基端部３２Ａに接触させながら、操作コイル３２を前進させることができる。 The proximal end portion 32A of the operation coil 32 is located on the distal end side with respect to the slider 72. By advancing the slider 72, the operation coil 32 can be advanced while the end surface (second contact portion) 72A on the distal end side of the slider 72 is in contact with the base end portion 32A of the operation coil 32.
　操作ワイヤ３１は、スライダ７２に形成された貫通孔７３を通ってスライダ７２よりも基端側まで延びている。操作ワイヤ３１の基端部３１Ａには例えば円盤状の拡径部材７４が取り付けられている。これにより、操作ワイヤ３１の基端部３１Ａの径が拡大され、拡径部材７４が貫通孔７３内に進入できない構成を有する。したがって、スライダ７２を後退させると、スライダ７２の基端側の端面（第一当接部）７２Ｂを操作ワイヤ３１の拡径部材７４に接触させて操作ワイヤ３１を牽引することができる。 The operation wire 31 extends through the through hole 73 formed in the slider 72 to the proximal end side than the slider 72. For example, a disc-shaped diameter-expanding member 74 is attached to the proximal end portion 31 </ b> A of the operation wire 31. Thereby, the diameter of the base end portion 31 </ b> A of the operation wire 31 is enlarged, and the diameter-expanding member 74 cannot enter the through hole 73. Therefore, when the slider 72 is retracted, the end surface (first contact portion) 72B on the base end side of the slider 72 can be brought into contact with the diameter-expanding member 74 of the operation wire 31 and the operation wire 31 can be pulled.
　本実施形態に係る内視鏡用処置具６１においても、第一実施形態の内視鏡用処置具１同様、操作部材を前進させるとき、および後退させるときのいずれにおいても操作力量を好適に処置部に伝達することができる。 In the endoscope treatment tool 61 according to the present embodiment as well, like the endoscope treatment tool 1 in the first embodiment, the amount of operation force is suitably treated both when the operation member is advanced and when the operation member is moved backward. Can be transmitted to the part.
　また、本実施形態に係る内視鏡用処置具６１においては、スライダ７２が後退するときは、スライダ７２と操作コイル３２とが非接触の状態となって操作ワイヤ３１だけが牽引される。スライダ７１が前進するときは、スライダ７２と操作ワイヤ３１とが非接触の状態となって操作コイル３２だけが押圧される。すなわち、操作部材を牽引および押圧する際に、スライダ７２がそれぞれの操作において好適に力量を伝達できる部材のみと接触する。その結果、もう一方の操作部材と接触することによる力量伝達のロスがなくなり、さらに好適に操作力量を処置部に伝達することができる。 Further, in the endoscope treatment tool 61 according to the present embodiment, when the slider 72 is retracted, the slider 72 and the operation coil 32 are not in contact with each other, and only the operation wire 31 is pulled. When the slider 71 moves forward, the slider 72 and the operation wire 31 are not in contact with each other, and only the operation coil 32 is pressed. That is, when pulling and pressing the operation member, the slider 72 contacts only a member capable of suitably transmitting the force in each operation. As a result, there is no loss of force transmission due to contact with the other operation member, and the operation force can be more suitably transmitted to the treatment section.
　以上、本発明の内視鏡用処置具に係る各実施形態を説明したが、本発明の技術範囲は上記実施形態に限定されるものではなく、本発明の趣旨を逸脱しない範囲において構成要素の組み合わせを変えたり、各構成要素に種々の変更を加えたり、削除したりすることが可能である。 As mentioned above, although each embodiment which concerns on the treatment tool for endoscopes of this invention was described, the technical scope of this invention is not limited to the said embodiment, In the range which does not deviate from the meaning of this invention, it is a component. It is possible to change the combination, to add various changes to the components, or to delete them.
　本発明の内視鏡用処置具において、処置部の構成は、上述した鉗子に限られない。以下に、処置部の他の例について示す。 In the endoscope treatment tool of the present invention, the configuration of the treatment section is not limited to the above-described forceps. Hereinafter, other examples of the treatment unit will be described.
　図４に示す処置部８０は、穿刺部８１と、採取部材８２とを備えた生検針である。穿刺部８１は、先端部が鋭利に形成されて組織に穿刺される。採取部材８２は、穿刺部８１に対して回転可能に取り付けられている。採取部材８２の先端側は、組織を収容できるようにカップ状に形成されており、採取部材８２の基端部８２Ａが、リンク８３を介して操作部材３０と接続されている。処置部８０は、穿刺部８１が内視鏡のチャンネル内壁を傷つけるのを防ぐため、外シース８５（挿入部）内に収容された状態ではチャンネルに挿入され、生検を行う際に外シース８５から突出される。 The treatment section 80 shown in FIG. 4 is a biopsy needle provided with a puncture section 81 and a collection member 82. The puncture portion 81 is sharply formed at the tip and is punctured into the tissue. The sampling member 82 is rotatably attached to the puncture portion 81. The distal end side of the collection member 82 is formed in a cup shape so as to accommodate the tissue, and the proximal end portion 82 </ b> A of the collection member 82 is connected to the operation member 30 via the link 83. The treatment section 80 is inserted into the channel when housed in the outer sheath 85 (insertion section) in order to prevent the puncture section 81 from damaging the channel inner wall of the endoscope, and the outer sheath 85 is used when performing a biopsy. Protruding from.
　処置部８０の使用時は、まず穿刺部８１が、組織を採取する臓器等に穿刺される。その後操作部材３０が前進されると、図５に示すように、採取部材８２が回動軸８４を中心に回転し、穿刺部８１の外周面から突出する。この状態で操作部材３０を後退させると、採取部材８２によって臓器等から組織の一部がかき取られて先端側のカップ状の空間に収容されるとともに、採取部材８２が穿刺部８１内に収容される。 When using the treatment unit 80, first, the puncture unit 81 is punctured into an organ or the like from which a tissue is collected. Thereafter, when the operation member 30 is advanced, the sampling member 82 rotates around the rotation shaft 84 and protrudes from the outer peripheral surface of the puncture portion 81 as shown in FIG. When the operating member 30 is retracted in this state, a part of the tissue is scraped off from the organ or the like by the sampling member 82 and is stored in the cup-shaped space on the distal end side, and the sampling member 82 is stored in the puncture portion 81. Is done.
　上述した処置部８０の操作のうち、採取部材８２を穿刺部８１の外周面から突出させる操作は、臓器等に穿刺された穿刺部８１の周囲に多量の組織が存在するために大きな力量が必要とされるが、操作部材３０が耐圧縮性に優れた操作コイル３２を備えているため、操作部材を前進させる操作力量が好適に処置部に伝達され、好適に組織採取手技を行うことができる。 Among the operations of the treatment unit 80 described above, the operation of causing the sampling member 82 to protrude from the outer peripheral surface of the puncture unit 81 requires a large amount of force because a large amount of tissue exists around the puncture unit 81 punctured into an organ or the like. However, since the operation member 30 includes the operation coil 32 having excellent compression resistance, the amount of operation force for advancing the operation member is suitably transmitted to the treatment section, and the tissue sampling procedure can be suitably performed. .
　図６に示す処置部９０も、上述の処置部８０同様、穿刺部と採取部材とを備えた生検針であるが、この処置部９０では、操作部材３０を後退させると採取部材９２が穿刺部８１の外周面から突出されるように構成されている。このように、操作部材と採取部材との接続態様を適宜変更することで、操作部材の進退と採取部材の動作との対応関係を適宜設定することができる。 The treatment unit 90 shown in FIG. 6 is also a biopsy needle provided with a puncture unit and a collection member, similar to the treatment unit 80 described above. It is comprised so that it may protrude from the outer peripheral surface of 81. FIG. Thus, by appropriately changing the connection mode between the operation member and the sampling member, the correspondence between the advance / retreat of the operation member and the operation of the sampling member can be set as appropriate.
　図７に示す処置部１００は、穿刺部１０１Ａを備えた内刃部１０１と、内刃部１０１が挿通された外刃部１０５とを備えた、いわゆる公知の傘状生検具として構成されている。内刃部１０１は、先端側に鋭利な穿刺部１０１Ａを有し、穿刺部１０１Ａよりも基端側に内刃１０２を有している。内刃１０２は、穿刺針１０１Ａの軸線を中心とした円周状に形成され、かつ基端側に向いた内刃１０２を有している。外刃部１０５は、操作部材３０が挿通されたコイルシース１１０の先端部に取り付けられており、外刃１０６を有している。外刃１０６は、内刃１０２と略同心状かつ内刃１０２より径の大きい円周状に形成されかつ先端側に向いている。内刃部１０１の基端部１０１Ｂは操作部材３０と接続されており、外刃部１０５に対して進退可能である。この図７では、基端部１０１Ｂの形状が接続部材３３と同様となっているが、基端部の形状に特に制限はない。 The treatment section 100 shown in FIG. 7 is configured as a so-called known umbrella-shaped biopsy instrument including an inner blade portion 101 provided with a puncture portion 101A and an outer blade portion 105 through which the inner blade portion 101 is inserted. Yes. The inner blade portion 101 has a sharp puncture portion 101A on the distal end side, and has an inner blade 102 on the proximal end side with respect to the puncture portion 101A. The inner blade 102 is formed in a circumferential shape centered on the axis of the puncture needle 101A and has an inner blade 102 facing the proximal end side. The outer blade portion 105 is attached to the distal end portion of the coil sheath 110 through which the operation member 30 is inserted, and has an outer blade 106. The outer blade 106 is formed in a circumferential shape that is substantially concentric with the inner blade 102 and has a larger diameter than the inner blade 102, and faces the distal end side. The base end portion 101 </ b> B of the inner blade portion 101 is connected to the operation member 30, and can advance and retreat with respect to the outer blade portion 105. In FIG. 7, the shape of the base end portion 101B is the same as that of the connecting member 33, but the shape of the base end portion is not particularly limited.
　傘状生検具では、内刃部を外刃部から突出した状態で内刃部のみを押し込んで狭窄部位等を突破させてから、内刃と外刃とを接近させて内刃と外刃との間に入り込んだ組織を切除して採取する操作が行われることがある。このとき、内刃部は、狭窄部位等の組織に押し返されるが、処置部１００を備えた本発明の内視鏡用処置具では、操作部材３０が耐圧縮性に優れた操作コイル３２を備えるため、操作部材を前進させる操作力量を、上述した押し返しの力に抗して好適に内刃部１０１に伝達することができる。その結果、比較的大きな力量が必要とされる狭窄部位の突破等も好適に行うことができる。 In the umbrella-shaped biopsy tool, with the inner blade part protruding from the outer blade part, only the inner blade part is pushed in to break through the constricted part, etc., and then the inner blade and outer blade are brought close to each other to bring the inner blade and outer blade closer together. An operation may be performed in which tissue that has entered between the two is excised and collected. At this time, the inner blade portion is pushed back to the tissue such as a stenosis site. However, in the endoscope treatment tool of the present invention provided with the treatment portion 100, the operation member 30 has the operation coil 32 having excellent compression resistance. Therefore, the amount of operating force for moving the operating member forward can be suitably transmitted to the inner blade portion 101 against the above-described pushing force. As a result, it is possible to suitably perform breakthrough of a stenosis site where a relatively large amount of force is required.
　図８に示す処置部１１０は、穿刺部１１１Ａを有する針管１１１と、針管１１１内に収容された切離部１１２とを備えた、いわゆる公知のギロチン式の生検針である。針管１１１の側面には、組織採取のための採取孔１１３が設けられている。切離部１１２は、基端側に向いた切刃１１４を有し、操作部材３０に接続されている。 The treatment section 110 shown in FIG. 8 is a so-called known guillotine-type biopsy needle including a needle tube 111 having a puncture portion 111A and a separation portion 112 accommodated in the needle tube 111. A collection hole 113 for collecting a tissue is provided on the side surface of the needle tube 111. The separation part 112 has a cutting blade 114 facing the proximal end side, and is connected to the operation member 30.
　針管１１１を穿刺部１１Ａから臓器等に刺入すると、当該臓器等の組織の一部が採取孔１１３から針管１１１の内腔に突出する。この状態で操作部材３０を後退させて切離部１１２を針管１１１に対して後退させると、針管１１１の内腔に突出した組織の一部が切刃１１４により切り離されて針管１１１内に収容される。 When the needle tube 111 is inserted into an organ or the like from the puncture portion 11A, a part of the tissue such as the organ protrudes from the collection hole 113 into the lumen of the needle tube 111. In this state, when the operating member 30 is retracted and the separating portion 112 is retracted with respect to the needle tube 111, a part of the tissue protruding into the lumen of the needle tube 111 is separated by the cutting blade 114 and accommodated in the needle tube 111. The
　ギロチン式の生検針においても、組織を好適に切り取るために切離部の前進および後退を複数回行うことがある。このとき、組織が針管の内腔に突出していると、切離部を前進させる際の障害となることがある。しかし、処置部１１０を備えた本実施形態に係る内視鏡用処置具では、操作コイル３２を備えた操作部材３０により、操作力量が好適に切離部１１２に伝達され、切離部１１２の前進操作を好適に行うことができる。 Also in the guillotine type biopsy needle, in order to cut out the tissue appropriately, the separation part may be advanced and retracted several times. At this time, if the tissue protrudes into the lumen of the needle tube, it may become an obstacle when the separation portion is advanced. However, in the endoscope treatment tool according to the present embodiment including the treatment unit 110, the operation force amount is suitably transmitted to the separation unit 112 by the operation member 30 including the operation coil 32, and the separation unit 112. The forward operation can be suitably performed.
　このように、本実施形態における操作部材は、前進および後退のいずれの操作力量も好適に処置部に伝達できる。このため、前進操作に対して比較的大きな力量が必要となる処置部と組み合わせると特に好適である。したがって、本発明に係る内視鏡用処置具における処置部の構成は、上述した鉗子および各種の生検針や生検具に限られないことは当然である。 As described above, the operation member in the present embodiment can suitably transmit both the forward and backward operation force amounts to the treatment section. For this reason, it is particularly suitable when combined with a treatment section that requires a relatively large force for forward operation. Therefore, it is natural that the configuration of the treatment portion in the endoscope treatment tool according to the present invention is not limited to the above-described forceps, various biopsy needles, and biopsy tools.
　また、上述の各実施形態においては、操作部材において、第一操作部材である操作ワイヤが第二操作部材である操作コイルに挿通された例を説明した。しかし、第一操作部材と第二操作部材の配置態様はこれには限られず、例えば第一操作部材と第二操作部材とが並走するように配置されても構わない。この場合は、操作コイルの内腔に操作ワイヤを通す空間を確保する必要がないため、操作コイルの内径を小さくすることが可能となる。
　また、第一操作部材と第二操作部材とは、必ずしも共通のスライダで操作されなくてもよい。第一操作部材と第二操作部材とは、別々のスライダに取り付けられてそれぞれ単独で操作可能とされてもよい。
　さらに、本実施形態における操作部材には、接続部材は必須ではない。したがって、第一操作部材および第二操作部材が、処置部に直接接続されても構わない。 Further, in each of the above-described embodiments, an example has been described in which the operation wire that is the first operation member is inserted into the operation coil that is the second operation member. However, the arrangement mode of the first operation member and the second operation member is not limited to this, and for example, the first operation member and the second operation member may be arranged so as to run in parallel. In this case, since it is not necessary to secure a space for passing the operation wire through the lumen of the operation coil, the inner diameter of the operation coil can be reduced.
Further, the first operating member and the second operating member do not necessarily have to be operated with a common slider. The first operating member and the second operating member may be attached to separate sliders and may be operated independently.
Furthermore, the connection member is not essential for the operation member in the present embodiment. Therefore, the first operation member and the second operation member may be directly connected to the treatment section.
　上記内視鏡用処置具によれば、操作部材を前進させるとき、および後退させるときのいずれにおいても操作力量を好適に処置部に伝達することができ、操作の容易な内視鏡用処置具を提供することができる。 According to the endoscope treatment tool, the endoscope treatment tool can easily transmit the operation force amount to the treatment portion both when the operation member is moved forward and when the operation member is moved backward. Can be provided.
１、６１：　内視鏡用処置具
１０、８５：　挿入部
２０、８０、９０、１００、１１０：　処置部
３１：　操作ワイヤ（第一操作部材）
３２：　操作コイル（第二操作部材）
５０、７０：　操作部
７２Ｂ：　第一当接部
７２Ａ：　第二当接部 1, 61: Endoscopic treatment tool 10, 85: Insertion unit 20, 80, 90, 100, 110: Treatment unit 31: Operation wire (first operation member)
32: Operation coil (second operation member)
50, 70: Operation part 72B: First contact part 72A: Second contact part

Claims (4)

  1. 可撓性を有する長尺の挿入部と、
    　前記挿入部の先端部に取り付けられ、生体内で所定の処置を行うための処置部と、
    　前記処置部に接続され、前記挿入部に対して後退することで前記処置部を動作させる第一操作部材と、
    　前記第一操作部材よりも高い耐圧縮性を有して前記処置部に接続され、前記挿入部に対して前進することで前記処置部を動作させる第二操作部材と、
    　前記挿入部の基端部に取り付けられ、前記第一操作部材および前記第二操作部材を操作するための操作部と、
    　を備える内視鏡用処置具。     A long insertion part having flexibility;
    A treatment part attached to the distal end of the insertion part and performing a predetermined treatment in vivo;
    A first operating member connected to the treatment section and operating the treatment section by moving backward with respect to the insertion section;
    A second operating member that has a higher compression resistance than the first operating member, is connected to the treatment section, and moves the treatment section by moving forward with respect to the insertion section;
    An operation unit that is attached to a proximal end portion of the insertion unit and operates the first operation member and the second operation member;
    An endoscopic treatment tool comprising:
  2. 前記操作部は、前記第一操作部材と当接する第一当接部と、前記第二操作部材と当接する第二当接部と、を有する請求項１に記載の内視鏡用処置具。 The endoscopic treatment instrument according to claim 1, wherein the operation portion includes a first contact portion that contacts the first operation member, and a second contact portion that contacts the second operation member.
  3. 前記第一当接部および前記第二当接部は、同一のスライダに設けられ、
    前記第一当接部および前記第二当接部は、前記第一当接部が前記第一操作部材と当接するときは、前記第二操作部材と前記第二当接部とが非接触の状態となって前記第一操作部材だけが操作され、前記第二当接部が前記第二操作部材と当接するときは、前記第一操作部材と前記第一接部とが非接触の状態となって前記第二操作部材だけが操作されるように設けられる請求項２に記載の内視鏡用処置具。     The first contact portion and the second contact portion are provided on the same slider,
    The first contact portion and the second contact portion are configured such that when the first contact portion contacts the first operation member, the second operation member and the second contact portion are not in contact with each other. When only the first operation member is operated and the second contact portion comes into contact with the second operation member, the first operation member and the first contact portion are in a non-contact state. The endoscope treatment tool according to claim 2, wherein the endoscope is provided so that only the second operation member is operated.
  4. 前記第二操作部材は、金属素線からなる操作コイルであり、
    　前記第一操作部材は、前記操作コイルに挿通されている請求項１に記載の内視鏡用処置具。     The second operation member is an operation coil made of a metal wire,
    The treatment instrument for an endoscope according to claim 1, wherein the first operation member is inserted through the operation coil.
PCT/JP2013/077345 2012-10-18 2013-10-08 Treatment tool for endoscope WO2014061505A1 (en)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
IT201800006731A1 (en) * 2018-06-27 2019-12-27 DEVICE FOR COLLECTING ORGANIC TISSUE SAMPLES
JP2020137949A (en) * 2019-03-01 2020-09-03 国立研究開発法人国立がん研究センター Biopsy needle

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH08164141A (en) * 1994-12-13 1996-06-25 Olympus Optical Co Ltd Treating tool
JP2011177231A (en) * 2010-02-26 2011-09-15 Patentstra Co Ltd Coiled structure used for medical treatment and method for manufacturing the same; and medical endoscope, medical treatment instrument and ultrasonic or optical interferometry diagnostic and medical treatment catheters using coiled structure for medical treatment

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH08164141A (en) * 1994-12-13 1996-06-25 Olympus Optical Co Ltd Treating tool
JP2011177231A (en) * 2010-02-26 2011-09-15 Patentstra Co Ltd Coiled structure used for medical treatment and method for manufacturing the same; and medical endoscope, medical treatment instrument and ultrasonic or optical interferometry diagnostic and medical treatment catheters using coiled structure for medical treatment

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
IT201800006731A1 (en) * 2018-06-27 2019-12-27 DEVICE FOR COLLECTING ORGANIC TISSUE SAMPLES
WO2020003198A1 (en) * 2018-06-27 2020-01-02 Euromedical S.R.L. Device for collecting samples of biological tissue
JP2020137949A (en) * 2019-03-01 2020-09-03 国立研究開発法人国立がん研究センター Biopsy needle
JP7263055B2 (en) 2019-03-01 2023-04-24 株式会社ナカニシ biopsy needle

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