WO2020021923A1 - Endoscopic treatment instrument - Google Patents

Endoscopic treatment instrument Download PDF

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Publication number
WO2020021923A1
WO2020021923A1 PCT/JP2019/024528 JP2019024528W WO2020021923A1 WO 2020021923 A1 WO2020021923 A1 WO 2020021923A1 JP 2019024528 W JP2019024528 W JP 2019024528W WO 2020021923 A1 WO2020021923 A1 WO 2020021923A1
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WO
WIPO (PCT)
Prior art keywords
main body
connector
rotation
sheath
treatment tool
Prior art date
Application number
PCT/JP2019/024528
Other languages
French (fr)
Japanese (ja)
Inventor
諒 石川
佐藤　純
Original Assignee
富士フイルム株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 富士フイルム株式会社 filed Critical 富士フイルム株式会社
Priority to CN201980048478.2A priority Critical patent/CN112449584A/en
Priority to JP2020532220A priority patent/JP6931427B2/en
Publication of WO2020021923A1 publication Critical patent/WO2020021923A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor

Definitions

  • the present invention relates to an endoscope treatment tool, and more particularly to an endoscope treatment tool that is inserted through a treatment instrument insertion channel of an endoscope and performs a treatment such as incision or peeling of a diseased mucous membrane portion.
  • ESD endoscopic submucosal dissection
  • Patent Document 1 As an endoscope treatment tool used for ESD, for example, a high-frequency treatment tool disclosed in Patent Document 1 is known.
  • the high-frequency treatment instrument disclosed in Patent Document 1 has a connector main body (connection pipe) between a flexible sheath having a high-frequency knife attached to the tip and an operation section main body (operation means) including a main body shaft and a slider.
  • the connector body is provided with a water injection connector (fluid connection part).
  • a syringe or a water supply tube (pipe) to the water injection connector.
  • Patent Literature 2 discloses a catheter device for removing gallstones.
  • the catheter device restricts rotation of the handle and maintains the position of the endoscopic instrument by rotatably mounting the handle relative to the catheter hub assembly and engaging the interlocking detents with each other.
  • the handle is configured to be rotatable with a frictional force with respect to the catheter hub assembly.
  • the high-frequency treatment tool disclosed in Patent Document 1 shows a mode in which the connector main body is connected to the operation unit main body. Is the connector main body non-rotatably connected to the operation unit main body? It is unknown whether they are rotatably connected.
  • the syringe can be easily connected to the water injection connector, and the syringe is oriented in a predetermined direction even when operating the high-frequency treatment instrument. Since the state is maintained, the operation is easy even when the syringe is connected and operated.
  • a water supply tube is connected to the water injection connector and used, if the positional relationship between the endoscope treatment tool and the water supply tube fluctuates, the water supply tube may hinder the operation of the endoscope treatment tool. As a result, operability is likely to be reduced.
  • the catheter device disclosed in Patent Document 2 also has the same problem because the catheter hub assembly and the handle are attached with a frictional force.
  • the present invention has been made in view of such circumstances, and an object of the present invention is to provide an endoscope treatment tool which is easy to use regardless of whether a syringe or a water supply tube is connected to a water injection connector.
  • an endoscope treatment tool of the present invention includes a flexible sheath, a wire inserted inside the sheath, a treatment section provided at a distal end of the wire, and a sheath.
  • a tubular connector body having a proximal end connected thereto, a water injection connector provided on the connector main body, and an operation portion main body connected to the proximal end of the connector main body, wherein the wire is advanced and retracted in the axial direction of the sheath.
  • the operation portion main body operates between a rotation lock state in which the engaged portion is engaged to lock the connector body so that it cannot rotate, and a rotation lock release state in which the engagement is released and the connector body can rotate. It has a possible movable engagement body.
  • the movable engagement body is a slide switch that can slide in the axial direction of the rotation shaft.
  • the slide switch has a slide ring and a protrusion provided on the slide ring, and the protrusion is engaged by sliding movement of the slide ring in the axial direction of the rotation shaft. It is preferable to engage with the portion to enter the rotation locked state.
  • the movable engagement body is a swing switch that can swing around a direction orthogonal to the axial direction of the rotation shaft.
  • a rocking switch has a rocking body and a projection provided on the rocking body, and the rocking body rocks around a direction orthogonal to an axial direction of a rotation axis. It is preferable that the projection is engaged with the engaged portion to be in a rotation locked state.
  • a plurality of engaged portions are provided in the circumferential direction of the rotation shaft in the connector body.
  • an endoscope treatment tool of the present invention includes a flexible sheath, a wire inserted inside the sheath, a treatment section provided at a distal end of the wire, and a sheath.
  • a tubular connector body having a proximal end connected thereto, a water injection connector provided on the connector main body, and an operation portion main body connected to the proximal end of the connector main body, wherein the wire is advanced and retracted in the axial direction of the sheath.
  • An operating section main body for projecting and retracting the treatment section from the distal end of the sheath, wherein the connector main body is rotatably connected to the operating section main body around a rotation axis, and the operating section main body is connected to the operating section main body by the connector main body.
  • a connecting member capable of transitioning from a rotation lock state in which the connector body is locked so that the connector body cannot be rotated by being connected to a rotation lock release state in which the connector body can be rotated by releasing the connection.
  • the center axis of the water injection connector faces the second direction orthogonal to the first direction in the horizontal direction.
  • the angle difference between the rotation angle of the connector body in the rotation locked state and the reference angle is preferably within a range of 45 degrees.
  • the center axis of the water injection connector is preferably orthogonal to the rotation axis.
  • the operation unit main body is provided with a main body shaft portion rotatably connected to the connector main body and extending in the direction of the rotation axis, and is provided movably along the main body shaft portion, And a connector provided on the slider and electrically connected to the proximal end of the wire, and it is preferable that the treatment section can be energized.
  • Perspective view of the high-frequency treatment tool viewed from another direction
  • Top view of high-frequency treatment tool Assembled perspective view showing components of the high-frequency treatment tool separated
  • FIG. 1 An enlarged perspective view showing a modification of the lock switch of FIG.
  • Main part enlarged perspective view of lock switch using slide ring Main part enlarged perspective view of a high-frequency treatment tool provided with a rocking type lock switch
  • An enlarged perspective view showing a modification of the lock switch of FIG. Enlarged view of main part of high-frequency treatment instrument in which connector main body and main body shaft are connected by a destructible connecting member
  • a high-frequency treatment tool used for ESD will be described as an example of an endoscope treatment tool.
  • the endoscope treatment tool of the present invention is an endoscope treatment tool that performs treatment other than this kind. Is also applicable.
  • FIG. 1 is an overall perspective view showing an example of the high-frequency treatment device 10 according to the first embodiment, and is a perspective view of the high-frequency treatment device 10 as viewed from one direction.
  • FIG. 2 is a perspective view of the high-frequency treatment instrument 10 viewed from another direction.
  • FIG. 3 is a plan view of the high-frequency treatment device 10
  • FIG. 4 is an assembled perspective view of the high-frequency treatment device 10 in which constituent members of the high-frequency treatment device 10 are shown separately.
  • the high-frequency treatment instrument 10 includes a flexible sheath 12, a wire 14 inserted inside the sheath 12, a high-frequency knife 16 provided at a distal end of the wire 14, and a connector body 18. , A water injection connector 20 provided on the connector main body 18, and an operation section main body 22.
  • the sheath 12 is formed in a long shape by an insulating member, and is inserted into a treatment tool insertion channel of an endoscope (not shown) at the time of ESD treatment. Note that the sheath 12 is shown only in FIG. 1, and the illustration of the sheath 12 is omitted in FIG. 2 and subsequent drawings.
  • the wire 14 is provided with a high-frequency knife 16 as an example of a treatment section at the tip thereof.
  • the proximal end of the wire 14 is inserted into the internal space 24 (see FIG. 4) of the connector main body 18 and connected to the core 56 (see FIG. 4) of the operation section main body 22.
  • the wire 14 of the embodiment is configured by covering a conductive wire (not shown) with an insulating film (not shown).
  • FIG. 5 is an enlarged perspective view of the connector main body 18.
  • FIG. 6 is a perspective view particularly showing the internal space 24 of the connector main body 18.
  • the connector main body 18 is a cylindrical member that connects the base end of the sheath 12 and the distal end of the operation section main body 22, and has a rotation shaft 28 with respect to the operation section main body 22. Is rotatably connected to
  • a finger hook 19A and a non-slip portion 19B are provided on the outer peripheral surface 18C of the connector body 18.
  • the finger hook 19A is provided on the operation unit main body 22 side
  • the non-slip portion 19B is provided on the sheath 12 side.
  • a plurality of substantially elliptical curved surfaces having a major axis in the direction of the rotation shaft 28 are formed on the finger hook 19A along the circumferential direction of the outer peripheral surface 18C.
  • a plurality of grooves are formed in the non-slip portion 19B along the direction of the rotation shaft 28 along the circumferential direction of the outer peripheral surface 18C.
  • a water injection connector 20 is formed on the connector body 18 so as to protrude toward the side.
  • the water injection connector 20 is formed in a cylindrical shape, and a water injection path 21 is formed therein.
  • One end of the water injection path 21 communicates with the internal space 24 of the connector body 18.
  • the other end of the water injection path 21 is open at the end of the water injection connector 20.
  • the water injection connector 20 is connected to the connector main body 18 in a direction in which a central axis 30 of the water injection connector 20 is orthogonal to the rotation axis 28 of the connector main body 18.
  • the endoscope treatment tool of the present invention is not limited to the above-described connection form, and may be a form in which the central axis 30 is inclined and connected to the rotation shaft 28.
  • either the syringe 32 shown in FIG. 7 or the water supply tube 34 shown in FIG. 8 is selected and connected to the water injection connector 20.
  • a liquid such as a physiological saline solution
  • the liquid flows from the internal space 24 of the water injection connector 20 shown in FIG. 1), and then ejected from the distal end 26 of the sheath 12 to the outside.
  • the water injection connector 20 will be described later.
  • the operation unit main body 22 includes a main body shaft 36, a slider 38, and an electric connector 40.
  • the slider 38 is indicated by a two-dot chain line.
  • the main body shaft portion 36 is a shaft-like member extending along the rotation shaft 28.
  • the main body shaft portion 36 has a longitudinal axis 36 ⁇ / b> A that is coaxial with the rotation shaft 28.
  • a connecting pipe 42 is provided coaxially with the longitudinal axis 36 ⁇ / b> A at the tip of the main body shaft 36.
  • An O-ring 44 for stopping water is mounted on the connecting pipe 42, and the connector main body 18 is rotatably connected to the connecting pipe 42 via the O-ring 44.
  • the connecting pipe 42 is configured to have a smaller diameter than the diameter of the main body shaft 36.
  • the connector main body 18 has the connecting pipe 42 fitted into the opening 18A at the base of the connector main body 18 via the O-ring 44, and is rotatably connected to the connecting pipe 42 while ensuring watertightness.
  • Finger ring 46 into which the operator's thumb is inserted is provided at the base end of main body shaft portion 36. Further, a slit 48 is formed in the main body shaft portion 36. The slit 48 is formed along the longitudinal axis 36A.
  • the slider 38 has a cylindrical portion 50 into which the main body shaft portion 36 is inserted, and finger hanging rings 52 and 54 into which the index finger and the middle finger of the operator are inserted.
  • These finger hanging rings 52 and 54 are provided integrally on the side surface of the tubular portion 50 with the tubular portion 50 interposed therebetween.
  • a core 56 fixed to the tubular portion 50 is provided inside the tubular portion 50.
  • the core 56 is slidably fitted to the slit 48 in a state where rotation about the longitudinal axis 36A is restricted. Therefore, the slider 38 can reciprocate along the longitudinal axis 36A in a state where the rotation about the longitudinal axis 36A is regulated by the rotation regulating action of the slit 48 and the core 56 with respect to the main body shaft portion 36. It is installed.
  • the electric connector 40 is provided on the core 56.
  • the electrical connector 40 is electrically connected to the proximal end of the wire 14 inside the core 56.
  • the electric connector 40 is connected to a high-frequency power supply (not shown) via a cable during ESD treatment.
  • the index finger and the middle finger of the operator are inserted into the finger hanging rings 52 and 54, and the thumb is inserted into the finger hanging ring 46. Thereafter, when the index finger and the middle finger are moved toward and away from the thumb, the slider 38 reciprocates along the longitudinal axis 36A.
  • the wire 14 is advanced and retracted in the axial direction of the sheath 12, so that the high-frequency knife 16 can be protruded and retracted from the distal end 26 of the sheath 12.
  • a high-frequency current from a high-frequency power supply is supplied to the high-frequency knife 16 from the electric connector 40 via the wire 14. Thereby, the lesion mucous membrane can be excised by the high-frequency knife 16.
  • the high-frequency treatment tool 10 of the first embodiment is easy to use regardless of whether the syringe 32 (see FIG. 7) or the water supply tube 34 (see FIG. 8) is connected to the water injection connector 20.
  • the syringe 32 see FIG. 7
  • the water supply tube 34 see FIG. 8
  • the slide lock switch 60 is configured by the engaged portion 62 and the movable engagement body.
  • FIG. 9 is an enlarged perspective view of a main part showing the configuration of the lock switch 60.
  • the engaged portion 62 is formed by a concave groove on the outer peripheral surface 18C of the connector main body 18.
  • the movable engagement body 64 constitutes a slide switch that is slidable along the axial direction of the rotary shaft 28 with respect to a guide groove 66 (see 9A in FIG. 9) provided on the outer peripheral surface 36C of the main body shaft portion 36. It is.
  • FIG. 10 is a cross-sectional view taken along line XX of FIG. 3, and is an explanatory diagram showing the positional relationship among the connector main body 18, the water injection connector 20, and the connecting pipe 42 as viewed from the direction of arrow A in FIG. .
  • the state of FIG. 10 shows a rotation locked state in which the movable engagement body 64 is engaged with the engaged portion 62.
  • the posture of the high-frequency treatment instrument 10 in which the rotation shaft 28 is oriented in the horizontal direction and the finger hanging rings 52 and 54 (see FIG. 7) are oriented in the vertical direction (hereinafter, the basic operation posture) ),
  • the center axis 30 of the water injection connector 20 is oriented in a horizontal direction orthogonal to the rotation axis 28.
  • the rotation lock is released (that is, the engagement between the engaged portion 62 and the movable engagement body 64 is released). .
  • the connector main body 18 is rotated in the direction of arrow B from the position of the rotation locked state in FIG. 10 so that the water injection connector 20 is directed downward in the vertical direction (that is, the center axis 30 of the water injection connector 20 is directly below). Facing position).
  • the rotation lock released state even if a change occurs in the positional relationship between the high-frequency treatment instrument 10 and the water supply tube 34, the change can be absorbed by the rotation of the connector body 18. Thereby, the operability of the high-frequency treatment instrument 10 is improved.
  • the connector main body 18 is rotatably connected to the operating section main body 22 about the rotation shaft 28, and the engaged A movable engagement member 64 provided on the operation portion main body 22, and the movable engagement member 64 is engaged with the engaged portion 62 to lock the connector main body 18 in a rotationally locked state.
  • a rotation unlocked state in which the engagement is released and the connector main body 18 can be rotated, so that even when the syringe 32 or the water supply tube 34 is connected to the water injection connector 20 and used, it is easy to use. Will be better.
  • the position where the central axis 30 of the water injection connector 20 is oriented in the horizontal direction is set to the position of the rotation lock state (see FIG. 7).
  • the position in the rotation locked state is not limited to this position.
  • the position of the rotation locked state may be any range where the usability is not impaired, regardless of whether the syringe 32 or the water supply tube 34 is connected to the water injection connector 20.
  • the position in the rotation locked state may be any range as long as the angle difference between the rotation angle of the connector main body 18 in the rotation locked state and the reference angle is within ⁇ 45 degrees.
  • the central axis 30 of the water injection connector 20 is orthogonal to the first direction of the horizontal direction as shown in FIG. 10. This is the rotation angle of the connector main body 18 when facing in two directions.
  • FIG. 11 is a perspective view of a main part showing a high-frequency treatment instrument 10A according to the second embodiment.
  • the lock switch 70 shown in FIG. 11 is provided with a plurality of engaged portions 62, 62... On the outer peripheral surface 18C of the connector main body 18 in the circumferential direction around the rotation shaft 28. Is the same as the lock switch 60 of FIG. According to the lock switch 70 of FIG. 11, the engaged portion 62 to be engaged with the movable engagement body 64 can be selected from a plurality of engaged portions 62, 62. In this case, the direction of the water injection connector 20 can be changed to a desired position.
  • FIG. 12 is a perspective view of a main part showing a high-frequency treatment instrument 10B according to the third embodiment.
  • the lock switch 80 shown in FIG. 12 includes a slide switch 82 instead of the movable engagement body 64 in FIG.
  • the slide switch 82 has a slide ring 84 and a projection 86 provided on the slide ring 84.
  • the slide ring 84 is mounted on the outer peripheral surface 36 ⁇ / b> C of the main body shaft 36.
  • a convex guide portion 88 is provided on the inner peripheral surface of the slide ring 84.
  • the guide portion 88 is slidably engaged with the guide groove 66 provided on the outer peripheral surface 36 ⁇ / b> C of the main body shaft portion 36.
  • the guide groove 66 is provided along the longitudinal axis 36A.
  • the slide ring 84 is provided slidably with respect to the main body shaft 36 along the longitudinal axis 36A.
  • the slide switch 82 configured as described above, when the slide ring 84 is slid toward the engaged portion 62, the protrusion 86 is engaged with the engaged portion 62. Thereby, the connector main body 18 is in a rotation locked state in which the connector main body 18 is locked so as not to rotate.
  • the lock switch 80 by providing the lock switch 80, the operator can check the slide ring 84 regardless of the operation posture, so that the rotation lock state is achieved.
  • the switching operability between the rotation lock release state and the rotation lock release state is improved, and the usability is further improved.
  • FIG. 13 is a perspective view of a main part showing a high-frequency treatment instrument 10C according to the fourth embodiment.
  • This high-frequency treatment instrument 10C includes an oscillating lock switch 90 that switches the rotation of the connector main body 18 between a rotation lock state and a rotation lock release state.
  • the lock switch 90 includes an engaged portion 92 provided on the connector main body 18 and a movable engagement body 94 provided on the main body shaft 36.
  • the engaged portion 92 is formed by a concave groove on the outer peripheral surface 18C of the connector main body 18.
  • the movable engagement body 104 constitutes a swing switch, and has a swing body 96 and an engagement portion 98 that can be engaged with the engaged portion 102.
  • the oscillating body 96 and the engaging portion 98 are each plate-shaped, and the engaging portion 98 is formed by a protruding portion protruding from an end of the oscillating body 96, and the oscillating body 96 and the engaging portion 98 are interposed therebetween. It is configured in a V-shape in side view via a provided bearing portion 99.
  • the bearing portion 99 is provided so as to be able to swing around a pin 100 provided on the outer peripheral surface 36 ⁇ / b> C of the main body shaft portion 36, and the pin 100 is attached in a direction orthogonal to the direction of the rotating shaft 28. .
  • the following effects can be obtained by providing the lock switch 90 as described above.
  • the engagement portion 98 is at a position where the engagement portion 98 is engaged with the engaged portion 92 (ie, a position where the engaged portion 92 faces the engagement portion 98).
  • the swinging body 96 is swung in the direction of arrow C to engage the engaging portion 98 with the engaged portion 92, thereby bringing the connector main body 18 into a rotation locked state.
  • the operability when the syringe 32 is connected is improved, and the usability is improved.
  • the swinging body 96 is swung in the direction of arrow D to move the engaging portion 98 away from the engaged portion 92 to move the connector.
  • the main body 18 is brought into the rotation lock released state.
  • FIG. 14 is a perspective view of a main part showing a high-frequency treatment instrument 10D according to the fifth embodiment.
  • the lock switch 110 shown in FIG. 14 is provided with a plurality of engaged portions 92, 92...
  • the engaged portion 92 to be engaged with the engaging portion 98 can be selected from a plurality of engaged portions 92, 92.
  • the direction of the water injection connector 20 can be changed to a desired position.
  • FIG. 15 is a perspective view of a main part showing a high-frequency treatment instrument 10E according to the sixth embodiment.
  • the main body shaft portion 36 shown in FIG. 15 has a connecting member 120.
  • the connecting member 120 is connected to the main body shaft portion 36 to lock the connector main body 18 in a non-rotatable state. By releasing the connection, it is possible to make a transition to a rotation lock release state in which the connector main body 18 can be rotated.
  • the connecting member 120 shown in FIG. 15 includes a plurality of bridge pieces 122 that can be broken by transmitting a rotational force. Are provided at intervals around the distal end of the main body shaft portion 36, and are connected around the proximal end of the connector main body 18.
  • the connector main body 18 is connected to the main body shaft portion 36 via the bridge pieces 122, 122.
  • the connector main body 18 is rotated about the rotary shaft 28 with respect to the main body shaft portion 36, all of the bridge pieces 122 are broken by the rotational force. That is, when all of the bridge pieces 122 are broken, the connector main body 18 transitions from the rotation lock state to the rotation lock release state.
  • the following effects can be obtained by providing the above-described connecting member 120.
  • the rotation locked state is maintained.
  • the operability when the syringe 32 is connected is improved, and the usability is improved.
  • the connector body 18 is rotated with respect to the main body shaft 36 to break all the bridge pieces 122, 122,.
  • the lock is released.
  • the operability when the water supply tube 34 is connected is improved, and the usability is improved.
  • the connector main body 18 can be transitioned from the rotation lock state to the rotation lock release state. This is suitable for the disposable type high-frequency treatment tool 10E that is discarded during use.

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Abstract

Provided is an endoscopic treatment instrument that is suitable for use with both a syringe and a water delivery tube. The present invention comprises a sheath (12), a wire (14), a high-frequency knife (16), a connector main body (18), a water injection connector (20), and an operation part main body (22). The connector main body (18) is connected to the operation part main body (22) so as to be capable of rotating around a rotational axis (28). The connector main body (18) has an engaged part (62), and the operation part main body (22) has a mobile engagement body (64) that can be operated between: a rotation-locked state in which the mobile engagement body (64) is engaged by the engaged part (62), and the connector main body (18) is locked so as to be incapable of rotating; and a rotation-unlocked state in which the mobile engagement body (64) is disengaged, and the connector main body (18) can rotate.

Description

内視鏡処置具Endoscope treatment tool
　本発明は内視鏡処置具に係り、特に内視鏡の処置具挿通チャンネルに挿通されて、病変粘膜部の切開又は剥離等の処置を行う内視鏡処置具に関する。 The present invention relates to an endoscope treatment tool, and more particularly to an endoscope treatment tool that is inserted through a treatment instrument insertion channel of an endoscope and performs a treatment such as incision or peeling of a diseased mucous membrane portion.
  内視鏡による処置の一例として、内視鏡的粘膜下層剥離術（ＥＳＤ：Endoscopic  Submucosal Dissection）が知られている。ＥＳＤは、内視鏡検査によって食道、胃、十二指腸、又は大腸等の体腔内壁における粘膜部分に腫瘍等の病変部が発見された場合、内視鏡処置具を用いて病変粘膜を切除する処置である。 As an example of an endoscopic procedure, endoscopic submucosal dissection (ESD) is known. ESD is a treatment in which a lesion such as a tumor is found in a mucous membrane portion of an inner wall of a body cavity such as an esophagus, a stomach, a duodenum, or a large intestine by endoscopy, and the lesion mucosa is removed using an endoscopic treatment tool. is there.
  ＥＳＤに用いられる内視鏡処置具としては、例えば特許文献１に開示された高周波処置具が知られている。 高周波 As an endoscope treatment tool used for ESD, for example, a high-frequency treatment tool disclosed in Patent Document 1 is known.
　特許文献１の高周波処置具は、先端に高周波ナイフが装着された可撓性シースと、本体軸及びスライダからなる操作部本体（操作手段）と、の間にコネクタ本体（接続パイプ）が備えられており、コネクタ本体には注水コネクタ（流体接続部）が設けられている。この高周波処置具では、注水コネクタにシリンジ又は送水チューブ（配管）等を接続することが可能となっている。 The high-frequency treatment instrument disclosed in Patent Document 1 has a connector main body (connection pipe) between a flexible sheath having a high-frequency knife attached to the tip and an operation section main body (operation means) including a main body shaft and a slider. The connector body is provided with a water injection connector (fluid connection part). In this high-frequency treatment instrument, it is possible to connect a syringe or a water supply tube (pipe) to the water injection connector.
　なお、ＥＳＤ用の内視鏡処置具ではないが、特許文献２には、胆石除去を行うカテーテル装置が開示されている。このカテーテル装置は、カテーテルハブアセンブリに対してハンドルを回転自在に設け、かつ、噛合い式の戻り止めを互いに係合させることにより、ハンドルの回転を規制して内視鏡器具の位置を維持するようにしている。また、このカテーテル装置では、カテーテルハブアセンブリに対してハンドルが摩擦力をもって回転可能に構成されている。 Although not an endoscope treatment tool for ESD, Patent Literature 2 discloses a catheter device for removing gallstones. The catheter device restricts rotation of the handle and maintains the position of the endoscopic instrument by rotatably mounting the handle relative to the catheter hub assembly and engaging the interlocking detents with each other. Like that. Further, in this catheter device, the handle is configured to be rotatable with a frictional force with respect to the catheter hub assembly.
特開２００８－２９６６７号公報JP 2008-29667 A 特表２００５－５１１１９５号公報JP-T-2005-511195
　特許文献１に開示された高周波処置具は、操作部本体に対してコネクタ本体が連結されている形態が示されているが、操作部本体に対してコネクタ本体が回転不能に連結されているのか、回転可能に連結されているのか不明である。 The high-frequency treatment tool disclosed in Patent Document 1 shows a mode in which the connector main body is connected to the operation unit main body. Is the connector main body non-rotatably connected to the operation unit main body? It is unknown whether they are rotatably connected.
　仮に、操作部本体に対してコネクタ本体が回転不能に連結された構成の場合、注水コネクタにシリンジを容易に接続することができ、高周波処置具の操作時においてもシリンジが所定の方向を向いた状態が維持されるため、シリンジの接続時及び操作時も含めて操作し易いものとなる。しかし、注水コネクタに送水チューブを接続して使用すると、内視鏡処置具と送水チューブとの位置関係に変動が生じた場合、送水チューブによって内視鏡処置具の操作を阻害してしまう場合があるので、操作性を低下させる原因となり易い。なお、特許文献２に開示されたカテーテル装置においても、カテーテルハブアセンブリとハンドルとが摩擦力をもって取り付けられているので、同様の問題がある。 If the connector body is non-rotatably connected to the operation unit body, the syringe can be easily connected to the water injection connector, and the syringe is oriented in a predetermined direction even when operating the high-frequency treatment instrument. Since the state is maintained, the operation is easy even when the syringe is connected and operated. However, if a water supply tube is connected to the water injection connector and used, if the positional relationship between the endoscope treatment tool and the water supply tube fluctuates, the water supply tube may hinder the operation of the endoscope treatment tool. As a result, operability is likely to be reduced. Note that the catheter device disclosed in Patent Document 2 also has the same problem because the catheter hub assembly and the handle are attached with a frictional force.
　一方、操作部本体に対してコネクタ本体が回転可能に連結された構成の場合、送水チュープの接続時には、内視鏡処置具と送水チューブとの位置関係に変動が生じても、コネクタ本体の回転により、その変動を吸収することができるため、操作性はよい。しかし、この構成の場合は、シリンジの接続時において、シリンジの自重によりコネクタ本体が回転してシリンジが垂れ下がってしまい、しかも高周波処置具の操作に応じてシリンジが揺れ動いてしまうので、操作性を低下させる要因となる。 On the other hand, in a configuration in which the connector main body is rotatably connected to the operation unit main body, even when the positional relationship between the endoscope treatment tool and the water supply tube fluctuates when the water supply tube is connected, the rotation of the connector main body is performed. Thus, the fluctuation can be absorbed, and the operability is good. However, in the case of this configuration, when the syringe is connected, the connector body rotates due to the weight of the syringe, and the syringe hangs down.Moreover, the syringe swings in accordance with the operation of the high-frequency treatment instrument, so that operability is reduced. It is a factor to make it.
　本発明はこのような事情に鑑みてなされたもので、注水コネクタにシリンジと送水チューブとのどちらが接続されて使用される場合でも使い勝手のよい内視鏡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 circumstances, and an object of the present invention is to provide an endoscope treatment tool which is easy to use regardless of whether a syringe or a water supply tube is connected to a water injection connector.
　本発明の目的を達成するために、本発明の内視鏡処置具は、可撓性のシースと、シースの内部に挿通されたワイヤと、ワイヤの先端に設けられた処置部と、シースの基端が連結された筒状のコネクタ本体と、コネクタ本体に設けられた注水コネクタと、コネクタ本体の基端に連結された操作部本体であって、ワイヤをシースの軸線方向に進退操作することにより処置部をシースの先端から突没させる操作部本体と、を備え、コネクタ本体は、操作部本体に対し回転軸を中心に回転自在に連結され、コネクタ本体は、被係合部を有し、操作部本体は、被係合部に係合されてコネクタ本体を回転不能にロックする回転ロック状態と、係合が解除されてコネクタ本体を回転可能にする回転ロック解除状態との間で動作可能な可動係合体を有する。 In order to achieve the object of the present invention, an endoscope treatment tool of the present invention includes a flexible sheath, a wire inserted inside the sheath, a treatment section provided at a distal end of the wire, and a sheath. A tubular connector body having a proximal end connected thereto, a water injection connector provided on the connector main body, and an operation portion main body connected to the proximal end of the connector main body, wherein the wire is advanced and retracted in the axial direction of the sheath. An operating section main body for projecting and retracting the treatment section from the distal end of the sheath, the connector main body is rotatably connected to the operating section main body around a rotation axis, and the connector main body has an engaged portion. The operation portion main body operates between a rotation lock state in which the engaged portion is engaged to lock the connector body so that it cannot rotate, and a rotation lock release state in which the engagement is released and the connector body can rotate. It has a possible movable engagement body.
　本発明の一形態によれば、可動係合体は、回転軸の軸方向にスライド移動可能なスライドスイッチであることが好ましい。 According to one aspect of the present invention, it is preferable that the movable engagement body is a slide switch that can slide in the axial direction of the rotation shaft.
　本発明の一形態によれば、スライドスイッチは、スライドリングと、スライドリングに設けられた突起部とを有し、スライドリングが回転軸の軸方向にスライド移動することで突起部が被係合部に係合して回転ロック状態となることが好ましい。 According to one embodiment of the present invention, the slide switch has a slide ring and a protrusion provided on the slide ring, and the protrusion is engaged by sliding movement of the slide ring in the axial direction of the rotation shaft. It is preferable to engage with the portion to enter the rotation locked state.
　本発明の一形態によれば、可動係合体は、回転軸の軸方向に直交する方向を中心に揺動可能な揺動スイッチであることが好ましい。 According to one embodiment of the present invention, it is preferable that the movable engagement body is a swing switch that can swing around a direction orthogonal to the axial direction of the rotation shaft.
　本発明の一形態によれば、揺動スイッチは、揺動体と、揺動体に設けられた突起部とを有し、揺動体が回転軸の軸方向に直交する方向を中心に揺動することで突起部が被係合部に係合して回転ロック状態となることが好ましい。 According to one embodiment of the present invention, a rocking switch has a rocking body and a projection provided on the rocking body, and the rocking body rocks around a direction orthogonal to an axial direction of a rotation axis. It is preferable that the projection is engaged with the engaged portion to be in a rotation locked state.
　本発明の一形態によれば、被係合部は、コネクタ本体における回転軸の周方向に複数備えられることが好ましい。 According to one aspect of the present invention, it is preferable that a plurality of engaged portions are provided in the circumferential direction of the rotation shaft in the connector body.
　本発明の目的を達成するために、本発明の内視鏡処置具は、可撓性のシースと、シースの内部に挿通されたワイヤと、ワイヤの先端に設けられた処置部と、シースの基端が連結された筒状のコネクタ本体と、コネクタ本体に設けられた注水コネクタと、コネクタ本体の基端に連結された操作部本体であって、ワイヤをシースの軸線方向に進退操作することにより処置部をシースの先端から突没させる操作部本体と、を備え、コネクタ本体は、操作部本体に対し回転軸を中心に回転自在に連結され、操作部本体は、操作部本体にコネクタ本体を連結することでコネクタ本体を回転不能にロックする回転ロック状態から、連結を解除することでコネクタ本体を回転可能にする回転ロック解除状態に遷移可能な連結部材を有する。 In order to achieve the object of the present invention, an endoscope treatment tool of the present invention includes a flexible sheath, a wire inserted inside the sheath, a treatment section provided at a distal end of the wire, and a sheath. A tubular connector body having a proximal end connected thereto, a water injection connector provided on the connector main body, and an operation portion main body connected to the proximal end of the connector main body, wherein the wire is advanced and retracted in the axial direction of the sheath. An operating section main body for projecting and retracting the treatment section from the distal end of the sheath, wherein the connector main body is rotatably connected to the operating section main body around a rotation axis, and the operating section main body is connected to the operating section main body by the connector main body. And a connecting member capable of transitioning from a rotation lock state in which the connector body is locked so that the connector body cannot be rotated by being connected to a rotation lock release state in which the connector body can be rotated by releasing the connection.
　本発明の一形態によれば、回転軸を水平方向のうち第１方向に沿って配置した状態において、注水コネクタの中心軸が水平方向のうち第１方向に直交する第２方向を向いた場合のコネクタ本体の回転角度を基準角度とした場合、回転ロック状態におけるコネクタ本体の回転角度と、基準角度との角度差が４５度以内の範囲であることが好ましい。 According to an embodiment of the present invention, in a state where the rotation axis is arranged along the first direction in the horizontal direction, the center axis of the water injection connector faces the second direction orthogonal to the first direction in the horizontal direction. When the rotation angle of the connector body is the reference angle, the angle difference between the rotation angle of the connector body in the rotation locked state and the reference angle is preferably within a range of 45 degrees.
　本発明の一形態によれば、注水コネクタの中心軸は、回転軸と直交していることが好ましい。 According to one embodiment of the present invention, the center axis of the water injection connector is preferably orthogonal to the rotation axis.
　本発明の一形態によれば、操作部本体は、コネクタ本体が回転自在に連結されて回転軸の方向に延出された本体軸部と、本体軸部に沿って移動自在に設けられ、ワイヤの基端部が連結されたスライダと、スライダに設けられ、ワイヤの基端部に電気的に接続された電気コネクタと、を有し、処置部に通電可能であることが好ましい。 According to one aspect of the present invention, the operation unit main body is provided with a main body shaft portion rotatably connected to the connector main body and extending in the direction of the rotation axis, and is provided movably along the main body shaft portion, And a connector provided on the slider and electrically connected to the proximal end of the wire, and it is preferable that the treatment section can be energized.
　本発明によれば、注水コネクタにシリンジと送水チューブとのどちらが接続されて使用される場合でも使い勝手がよい。 According to the present invention, it is easy to use regardless of which of the syringe and the water supply tube is connected to the water injection connector.
実施形態に係る高周波処置具を一方向から見た斜視図The perspective view which looked at the high frequency treatment tool concerning embodiment from one direction. 高周波処置具を他方向から見た斜視図Perspective view of the high-frequency treatment tool viewed from another direction 高周波処置具の平面図Top view of high-frequency treatment tool 高周波処置具の構成部材を分離して示した組み立て斜視図Assembled perspective view showing components of the high-frequency treatment tool separated コネクタ本体の拡大斜視図Enlarged perspective view of connector body コネクタ本体の内部空間を示した斜視図Perspective view showing the internal space of the connector body 注水コネクタにシリンジが接続された高周波処置具の斜視図Perspective view of a high-frequency treatment instrument with a syringe connected to the water injection connector 注水コネクタに送水チューブが接続された高周波処置具の斜視図Perspective view of high-frequency treatment instrument with water supply tube connected to water injection connector スライド式のロックスイッチを備えた高周波処置具の拡大斜視図Enlarged perspective view of a high-frequency treatment instrument provided with a slide lock switch 図３のＸ－Ｘ線に沿う断面図Sectional view along the line XX in FIG. 図９のロックスイッチの変形例を示した拡大斜視図An enlarged perspective view showing a modification of the lock switch of FIG. スライドリングを使用したロックスイッチの要部拡大斜視図Main part enlarged perspective view of lock switch using slide ring 揺動式のロックスイッチを備えた高周波処置具の要部拡大斜視図Main part enlarged perspective view of a high-frequency treatment tool provided with a rocking type lock switch 図１３のロックスイッチの変形例を示した拡大斜視図An enlarged perspective view showing a modification of the lock switch of FIG. コネクタ本体と本体軸部とを破壊可能な連結部材によって連結した高周波処置具の要部拡大図Enlarged view of main part of high-frequency treatment instrument in which connector main body and main body shaft are connected by a destructible connecting member
　以下、添付図面に基づいて本発明に係る内視鏡処置具の好ましい実施形態について説明する。 Hereinafter, preferred embodiments of the endoscope treatment tool according to the present invention will be described with reference to the accompanying drawings.
　以下の実施形態では、内視鏡処置具の一例として、ＥＳＤに使用される高周波処置具について説明するが、本発明の内視鏡処置具はこの種以外の処置を行う内視鏡処置具においても適用可能である。 In the following embodiments, a high-frequency treatment tool used for ESD will be described as an example of an endoscope treatment tool. However, the endoscope treatment tool of the present invention is an endoscope treatment tool that performs treatment other than this kind. Is also applicable.
　図１は、第１実施形態に係る高周波処置具１０の一例を示した全体斜視図であり、高周波処置具１０を一方向から見た斜視図である。これに対し、図２は、高周波処置具１０を他方向から見た斜視図である。また、図３は、高周波処置具１０の平面図であり、図４は、高周波処置具１０の構成部材を分離して示した高周波処置具１０の組み立て斜視図である。 FIG. 1 is an overall perspective view showing an example of the high-frequency treatment device 10 according to the first embodiment, and is a perspective view of the high-frequency treatment device 10 as viewed from one direction. On the other hand, FIG. 2 is a perspective view of the high-frequency treatment instrument 10 viewed from another direction. FIG. 3 is a plan view of the high-frequency treatment device 10, and FIG. 4 is an assembled perspective view of the high-frequency treatment device 10 in which constituent members of the high-frequency treatment device 10 are shown separately.
  図１に示すように、高周波処置具１０は、可撓性のシース１２と、シース１２の内部に挿入されたワイヤ１４と、ワイヤ１４の先端に設けられた高周波ナイフ１６と、コネクタ本体１８と、コネクタ本体１８に設けられた注水コネクタ２０と、操作部本体２２と、を備えている。 As shown in FIG. 1, the high-frequency treatment instrument 10 includes a flexible sheath 12, a wire 14 inserted inside the sheath 12, a high-frequency knife 16 provided at a distal end of the wire 14, and a connector body 18. , A water injection connector 20 provided on the connector main body 18, and an operation section main body 22.
　シース１２は、絶縁性部材によって長尺に構成されており、ＥＳＤの処置の際に不図示の内視鏡の処置具挿通チャンネルに挿通される。なお、シース１２は図１でのみ示し、図２以降ではシース１２の図示を省略している。 The sheath 12 is formed in a long shape by an insulating member, and is inserted into a treatment tool insertion channel of an endoscope (not shown) at the time of ESD treatment. Note that the sheath 12 is shown only in FIG. 1, and the illustration of the sheath 12 is omitted in FIG. 2 and subsequent drawings.
　ワイヤ１４は、その先端に処置部の一例である高周波ナイフ１６が設けられている。また、ワイヤ１４の基端は、コネクタ本体１８の内部空間２４（図４参照）に挿通されて操作部本体２２のコア５６（図４参照）に連結されている。実施形態のワイヤ１４は、一例として、導電線（不図示）を絶縁性被膜（不図示）によって被覆することにより構成されたものである。 The wire 14 is provided with a high-frequency knife 16 as an example of a treatment section at the tip thereof. The proximal end of the wire 14 is inserted into the internal space 24 (see FIG. 4) of the connector main body 18 and connected to the core 56 (see FIG. 4) of the operation section main body 22. As an example, the wire 14 of the embodiment is configured by covering a conductive wire (not shown) with an insulating film (not shown).
　図５は、コネクタ本体１８の拡大斜視図である。図６は、コネクタ本体１８の内部空間２４を特に示した斜視図である。図１から図６に示すように、コネクタ本体１８は、シース１２の基端と操作部本体２２の先端とを連結する筒状の部材であり、操作部本体２２に対して回転軸２８を中心に回転自在に連結されている。 FIG. 5 is an enlarged perspective view of the connector main body 18. FIG. 6 is a perspective view particularly showing the internal space 24 of the connector main body 18. As shown in FIGS. 1 to 6, the connector main body 18 is a cylindrical member that connects the base end of the sheath 12 and the distal end of the operation section main body 22, and has a rotation shaft 28 with respect to the operation section main body 22. Is rotatably connected to
　また、コネクタ本体１８の外周面１８Ｃには、指掛け部１９Ａと滑り止め部１９Ｂとが備えられている。指掛け部１９Ａは操作部本体２２側に備えられ、滑り止め部１９Ｂはシース１２側に備えられている。また、指掛け部１９Ａには、回転軸２８の方向に長径を有する複数の略楕円形状の曲面が外周面１８Ｃの周方向に沿って形成されている。滑り止め部１９Ｂには、回転軸２８の方向に沿った複数の溝が外周面１８Ｃの周方向に沿って形成されている。 外 周 Furthermore, a finger hook 19A and a non-slip portion 19B are provided on the outer peripheral surface 18C of the connector body 18. The finger hook 19A is provided on the operation unit main body 22 side, and the non-slip portion 19B is provided on the sheath 12 side. In addition, a plurality of substantially elliptical curved surfaces having a major axis in the direction of the rotation shaft 28 are formed on the finger hook 19A along the circumferential direction of the outer peripheral surface 18C. A plurality of grooves are formed in the non-slip portion 19B along the direction of the rotation shaft 28 along the circumferential direction of the outer peripheral surface 18C.
　図５及び図６に示すように、コネクタ本体１８には注水コネクタ２０が側方に向けて突出形成されている。注水コネクタ２０は、筒状に構成されており、その内部には注水経路２１が構成されている。注水経路２１の一端は、コネクタ本体１８の内部空間２４に連通されている。また、注水経路２１の他端は、注水コネクタ２０の端部の開口している。コネクタ本体１８に対して注水コネクタ２０は、一例として、注水コネクタ２０の中心軸３０がコネクタ本体１８の回転軸２８に直交する方向に連結されている。このような方向に注水コネクタ２０をコネクタ本体１８に連結することにより、高周波処置具１０の操作時において、後述するシリンジ３２（図７参照）又は送水チューブ３４（図８参照）が術者の操作の妨げにならないので、術者は高周波処置具１０の操作に専念することができる。なお、本発明の内視鏡処置具は、上記の連結形態に限定されるものではく、回転軸２８に対して中心軸３０が傾斜して連結された形態であってもよい。 5) As shown in FIGS. 5 and 6, a water injection connector 20 is formed on the connector body 18 so as to protrude toward the side. The water injection connector 20 is formed in a cylindrical shape, and a water injection path 21 is formed therein. One end of the water injection path 21 communicates with the internal space 24 of the connector body 18. The other end of the water injection path 21 is open at the end of the water injection connector 20. As an example, the water injection connector 20 is connected to the connector main body 18 in a direction in which a central axis 30 of the water injection connector 20 is orthogonal to the rotation axis 28 of the connector main body 18. By connecting the water injection connector 20 to the connector main body 18 in such a direction, a syringe 32 (see FIG. 7) or a water supply tube 34 (see FIG. 8) described later can be operated by the operator when the high-frequency treatment instrument 10 is operated. Therefore, the surgeon can concentrate on the operation of the high-frequency treatment device 10. In addition, the endoscope treatment tool of the present invention is not limited to the above-described connection form, and may be a form in which the central axis 30 is inclined and connected to the rotation shaft 28.
　注水コネクタ２０には、例えば、図７に示すシリンジ３２と図８に示す送水チューブ３４とのどちらかが選択されて接続される。シリンジ３２及び送水チューブ３４から、例えば生理食塩水等の液体が注水コネクタ２０の注水経路２１に供給されると、その液体は、図６に示した注水コネクタ２０の内部空間２４からシース１２（図１参照）の内部に供給され、その後、シース１２の先端２６から外部に噴射される。注水コネクタ２０については後述する。 For example, either the syringe 32 shown in FIG. 7 or the water supply tube 34 shown in FIG. 8 is selected and connected to the water injection connector 20. When a liquid such as a physiological saline solution is supplied from the syringe 32 and the water supply tube 34 to the water injection path 21 of the water injection connector 20, the liquid flows from the internal space 24 of the water injection connector 20 shown in FIG. 1), and then ejected from the distal end 26 of the sheath 12 to the outside. The water injection connector 20 will be described later.
　図４に戻り、操作部本体２２は、本体軸部３６と、スライダ３８と、電気コネクタ４０と、を有する。なお、図４ではスライダ３８を二点鎖線で示している。 Returning to FIG. 4, the operation unit main body 22 includes a main body shaft 36, a slider 38, and an electric connector 40. In FIG. 4, the slider 38 is indicated by a two-dot chain line.
　本体軸部３６は、回転軸２８に沿って延出された軸状の部材である。この本体軸部３６は、回転軸２８と同軸の長手軸３６Ａを有している。また、本体軸部３６の先端には、連結管４２が長手軸３６Ａと同軸上に設けられている。この連結管４２には、止水用のＯリング４４が装着されており、このＯリング４４を介してコネクタ本体１８が連結管４２に回転自在に連結される。 The main body shaft portion 36 is a shaft-like member extending along the rotation shaft 28. The main body shaft portion 36 has a longitudinal axis 36 </ b> A that is coaxial with the rotation shaft 28. A connecting pipe 42 is provided coaxially with the longitudinal axis 36 </ b> A at the tip of the main body shaft 36. An O-ring 44 for stopping water is mounted on the connecting pipe 42, and the connector main body 18 is rotatably connected to the connecting pipe 42 via the O-ring 44.
　具体的に説明すると、連結管４２は、本体軸部３６の直径よりも小径に構成されている。コネクタ本体１８は、連結管４２がコネクタ本体１８の基部の開口１８ＡにＯリング４４を介して嵌入されて、連結管４２に対し水密性を確保しつつ回転自在に連結される。 説明 Specifically, the connecting pipe 42 is configured to have a smaller diameter than the diameter of the main body shaft 36. The connector main body 18 has the connecting pipe 42 fitted into the opening 18A at the base of the connector main body 18 via the O-ring 44, and is rotatably connected to the connecting pipe 42 while ensuring watertightness.
　また、本体軸部３６の基端には、術者の親指が挿入される指掛けリング４６が設けられている。更に、本体軸部３６には、スリット４８が形成されている。このスリット４８は、長手軸３６Ａに沿って形成されている。 指 Finger ring 46 into which the operator's thumb is inserted is provided at the base end of main body shaft portion 36. Further, a slit 48 is formed in the main body shaft portion 36. The slit 48 is formed along the longitudinal axis 36A.
　一方、スライダ３８は、本体軸部３６が挿入される筒部５０と、術者の人差し指及び中指が挿入される指掛けリング５２、５４と有する。これらの指掛けリング５２、５４は、筒部５０を挟んで筒部５０の側面に一体的に設けられている。 On the other hand, the slider 38 has a cylindrical portion 50 into which the main body shaft portion 36 is inserted, and finger hanging rings 52 and 54 into which the index finger and the middle finger of the operator are inserted. These finger hanging rings 52 and 54 are provided integrally on the side surface of the tubular portion 50 with the tubular portion 50 interposed therebetween.
　筒部５０の内部には、筒部５０に固定されたコア５６が備えられている。このコア５６は、スリット４８に対し長手軸３６Ａを中心とする回転が規制された状態でスライド移動自在に嵌装されている。したがって、スライダ３８は、本体軸部３６に対し、スリット４８とコア５６とによる回転規制作用により、長手軸３６Ａを中心とする回転が規制された状態で、長手軸３６Ａに沿って往復移動自在に装着されている。 コ ア A core 56 fixed to the tubular portion 50 is provided inside the tubular portion 50. The core 56 is slidably fitted to the slit 48 in a state where rotation about the longitudinal axis 36A is restricted. Therefore, the slider 38 can reciprocate along the longitudinal axis 36A in a state where the rotation about the longitudinal axis 36A is regulated by the rotation regulating action of the slit 48 and the core 56 with respect to the main body shaft portion 36. It is installed.
　コア５６には、電気コネクタ４０が設けられている。電気コネクタ４０は、コア５６の内部においてワイヤ１４の基端に電気的に接続されている。この電気コネクタ４０は、ＥＳＤの処置の際に不図示の高周波電源にケーブルを介して接続される。 The electric connector 40 is provided on the core 56. The electrical connector 40 is electrically connected to the proximal end of the wire 14 inside the core 56. The electric connector 40 is connected to a high-frequency power supply (not shown) via a cable during ESD treatment.
　上記の如く構成された高周波処置具１０によれば、指掛けリング５２、５４に術者の人差し指及び中指を挿入し、指掛けリング４６に親指を挿入する。この後、親指に対して人差し指及び中指を近づく方向及び遠ざかる方向に動かすと、スライダ３８が長手軸３６Ａに沿って往復移動する。これにより、ワイヤ１４がシース１２の軸線方向に進退操作されるので、高周波ナイフ１６をシース１２の先端２６から突没させることができる。また、ＥＳＤの処置の際には、高周波電源からの高周波電流を、電気コネクタ４０からワイヤ１４を介して高周波ナイフ１６に通電する。これにより、高周波ナイフ１６によって病変粘膜を切除することができる。 According to the high-frequency treatment instrument 10 configured as described above, the index finger and the middle finger of the operator are inserted into the finger hanging rings 52 and 54, and the thumb is inserted into the finger hanging ring 46. Thereafter, when the index finger and the middle finger are moved toward and away from the thumb, the slider 38 reciprocates along the longitudinal axis 36A. Thus, the wire 14 is advanced and retracted in the axial direction of the sheath 12, so that the high-frequency knife 16 can be protruded and retracted from the distal end 26 of the sheath 12. In the case of ESD treatment, a high-frequency current from a high-frequency power supply is supplied to the high-frequency knife 16 from the electric connector 40 via the wire 14. Thereby, the lesion mucous membrane can be excised by the high-frequency knife 16.
　ところで、第１実施形態の高周波処置具１０は、注水コネクタ２０に対してシリンジ３２（図７参照）と送水チューブ３４（図８参照）とのどちらが接続された場合でも使い勝手がよいものとするために、以下の構成を有している。 By the way, the high-frequency treatment tool 10 of the first embodiment is easy to use regardless of whether the syringe 32 (see FIG. 7) or the water supply tube 34 (see FIG. 8) is connected to the water injection connector 20. Has the following configuration.
　すなわち、図１及び図４に示すように、コネクタ本体１８に設けられた被係合部６２と、操作部本体２２に設けられた可動係合体６４と、を有している。第１実施形態の高周波処置具１０では、被係合部６２と可動係合体とによってスライド式のロックスイッチ６０を構成している。 That is, as shown in FIGS. 1 and 4, it has an engaged portion 62 provided on the connector main body 18 and a movable engagement body 64 provided on the operation portion main body 22. In the high-frequency treatment instrument 10 according to the first embodiment, the slide lock switch 60 is configured by the engaged portion 62 and the movable engagement body.
　図９は、ロックスイッチ６０の構成を示した要部拡大斜視図である。図９の９Ａ及び９Ｂに示すように、被係合部６２は、コネクタ本体１８の外周面１８Ｃに凹状の溝部により構成されている。可動係合体６４は、本体軸部３６の外周面３６Ｃに備えられたガイド溝６６（図９の９Ａ参照）に対し、回転軸２８の軸方向に沿ってスライド移動可能なスライドスイッチを構成するものである。 FIG. 9 is an enlarged perspective view of a main part showing the configuration of the lock switch 60. As shown in FIGS. 9A and 9B, the engaged portion 62 is formed by a concave groove on the outer peripheral surface 18C of the connector main body 18. The movable engagement body 64 constitutes a slide switch that is slidable along the axial direction of the rotary shaft 28 with respect to a guide groove 66 (see 9A in FIG. 9) provided on the outer peripheral surface 36C of the main body shaft portion 36. It is.
　図９の９Ａに示すように、可動係合体６４を、被係合部６２（図９の９Ｂ参照）に向けてスライド移動すると、可動係合体６４が被係合部６２に係合される。これにより、コネクタ本体１８は、回転不能にロックされた回転ロック状態となる。また、可動係合体６４を、被係合部６２から退避する方向にスライド移動すると、被係合部６２と被係合部６２との係合が解除される。これにより、コネクタ本体１８は、図９の９Ｂに示すように、回転可能な回転ロック解除状態となる。すなわち、可動係合体６４は、回転ロック状態と回転ロック解除状態との間で動作可能に構成されている。 As shown in FIG. 9A, when the movable engagement body 64 is slid toward the engaged portion 62 (see 9B in FIG. 9), the movable engagement body 64 is engaged with the engaged portion 62. Thereby, the connector main body 18 is in a rotation locked state in which the connector main body 18 is locked so as not to rotate. In addition, when the movable engagement body 64 is slid in the direction to withdraw from the engaged portion 62, the engagement between the engaged portion 62 and the engaged portion 62 is released. As a result, the connector main body 18 enters a rotatable rotation unlocked state as shown in FIG. 9B. That is, the movable engagement body 64 is configured to be operable between the rotation lock state and the rotation lock release state.
　図１０は、図３のＸ－Ｘ線に沿う断面図であって、図３の矢印Ａ方向から見たコネクタ本体１８と注水コネクタ２０と連結管４２との位置関係を示した説明図である。また、図１０の状態は、可動係合体６４が被係合部６２に係合された回転ロック状態を示している。なお、図１０に示す回転ロック状態では、回転軸２８が水平方向に向き、かつ、指掛けリング５２、５４（図７参照）が鉛直方向に向いた高周波処置具１０の姿勢（以下、基本操作姿勢と言う。）において、注水コネクタ２０の中心軸３０が回転軸２８と直交する水平方向に向いた状態となっている。 FIG. 10 is a cross-sectional view taken along line XX of FIG. 3, and is an explanatory diagram showing the positional relationship among the connector main body 18, the water injection connector 20, and the connecting pipe 42 as viewed from the direction of arrow A in FIG. . Further, the state of FIG. 10 shows a rotation locked state in which the movable engagement body 64 is engaged with the engaged portion 62. In the rotation locked state shown in FIG. 10, the posture of the high-frequency treatment instrument 10 in which the rotation shaft 28 is oriented in the horizontal direction and the finger hanging rings 52 and 54 (see FIG. 7) are oriented in the vertical direction (hereinafter, the basic operation posture) ), The center axis 30 of the water injection connector 20 is oriented in a horizontal direction orthogonal to the rotation axis 28.
　注水コネクタ２０にシリンジ３２（図７参照）を接続して使用する場合には、回転ロック状態（すなわち、可動係合体６４が被係合部６２に係合された状態）にしておく。これにより、注水コネクタ２０にシリンジ３２を容易に接続することができる。また、高周波処置具１０の使用時にシリンジ３２が自重で垂れ下がったり揺れ動いたりするのを防止することができるので、操作性が向上する。 接 続 When the syringe 32 (see FIG. 7) is connected to the water injection connector 20 and used, the rotation lock state (that is, the movable engagement body 64 is engaged with the engaged portion 62) is kept. Thereby, the syringe 32 can be easily connected to the water injection connector 20. Further, since the syringe 32 can be prevented from hanging down or swinging by its own weight when the high-frequency treatment instrument 10 is used, the operability is improved.
　一方、可動係合体６４を被係合部６２から退避する方向にスライド移動させると、コネクタ本体１８は回転ロック解除状態となる。 On the other hand, when the movable engagement body 64 is slid in the direction of retreating from the engaged portion 62, the connector main body 18 enters the rotation lock released state.
　注水コネクタ２０に送水チューブ３４（図８参照）を接続して使用する場合には、回転ロック解除状態（すなわち、被係合部６２と可動係合体６４との係合を解除した状態）にする。具体的には、コネクタ本体１８を図１０の回転ロック状態の位置から矢印Ｂ方向に回転させて注水コネクタ２０が鉛直方向の下側に向く位置（すなわち、注水コネクタ２０の中心軸３０が真下に向く位置）に配置する。このような回転ロック解除状態では、高周波処置具１０と送水チューブ３４との位置関係に変動が生じても、コネクタ本体１８の回転によりその変動を吸収することができる。これにより、高周波処置具１０の操作性がよくなる。 When the water supply tube 34 (see FIG. 8) is connected to the water injection connector 20 for use, the rotation lock is released (that is, the engagement between the engaged portion 62 and the movable engagement body 64 is released). . Specifically, the connector main body 18 is rotated in the direction of arrow B from the position of the rotation locked state in FIG. 10 so that the water injection connector 20 is directed downward in the vertical direction (that is, the center axis 30 of the water injection connector 20 is directly below). Facing position). In such a rotation lock released state, even if a change occurs in the positional relationship between the high-frequency treatment instrument 10 and the water supply tube 34, the change can be absorbed by the rotation of the connector body 18. Thereby, the operability of the high-frequency treatment instrument 10 is improved.
　以上の如く、第１実施形態の高周波処置具１０によれば、コネクタ本体１８は、操作部本体２２に対し回転軸２８を中心に回転自在に連結され、コネクタ本体１８に設けられた被係合部６２と、操作部本体２２に設けられた可動係合体６４と、を有し、可動係合体６４は、被係合部６２に係合されてコネクタ本体１８を回転不能にロックする回転ロック状態と、係合が解除されてコネクタ本体１８を回転可能にする回転ロック解除状態との間で動作可能なので、注水コネクタ２０にシリンジ３２と送水チューブ３４とのどちらが接続されて使用される場合でも使い勝手がよいものとなる。 As described above, according to the high-frequency treatment instrument 10 of the first embodiment, the connector main body 18 is rotatably connected to the operating section main body 22 about the rotation shaft 28, and the engaged A movable engagement member 64 provided on the operation portion main body 22, and the movable engagement member 64 is engaged with the engaged portion 62 to lock the connector main body 18 in a rotationally locked state. And a rotation unlocked state in which the engagement is released and the connector main body 18 can be rotated, so that even when the syringe 32 or the water supply tube 34 is connected to the water injection connector 20 and used, it is easy to use. Will be better.
　なお、既述の第１実施形態では、高周波処置具１０の基本操作姿勢において、注水コネクタ２０の中心軸３０が水平方向に向く位置を回転ロック状態（図７参照）の位置に設定したが、回転ロック状態の位置は、この位置に限定されるものではない。つまり、回転ロック状態の位置は、注水コネクタ２０にシリンジ３２と送水チューブ３４とのどちらが接続された場合でも、使い勝手が損なわれない程度の範囲であればよい。具体的には、回転ロック状態の位置は、回転ロック状態におけるコネクタ本体１８の回転角度と、基準角度との角度差が±４５度以内の範囲であればよい。なお、基準角度とは、図１０の如く、回転軸２８を水平方向のうち第１方向に沿って配置した状態において、注水コネクタ２０の中心軸３０が水平方向のうち第１方向に直交する第２方向を向いた場合のコネクタ本体１８の回転角度である。このような範囲に、回転ロック状態の位置を設定することで、注水コネクタ２０にシリンジ３２と送水チューブ３４とのどちらが接続されて使用される場合でも使い勝手がよいものとなる。 In the first embodiment described above, in the basic operation posture of the high-frequency treatment instrument 10, the position where the central axis 30 of the water injection connector 20 is oriented in the horizontal direction is set to the position of the rotation lock state (see FIG. 7). The position in the rotation locked state is not limited to this position. In other words, the position of the rotation locked state may be any range where the usability is not impaired, regardless of whether the syringe 32 or the water supply tube 34 is connected to the water injection connector 20. Specifically, the position in the rotation locked state may be any range as long as the angle difference between the rotation angle of the connector main body 18 in the rotation locked state and the reference angle is within ± 45 degrees. In addition, as shown in FIG. 10, in the state where the rotating shaft 28 is arranged along the first direction of the horizontal direction, the central axis 30 of the water injection connector 20 is orthogonal to the first direction of the horizontal direction as shown in FIG. 10. This is the rotation angle of the connector main body 18 when facing in two directions. By setting the position of the rotation locked state in such a range, even when either the syringe 32 or the water supply tube 34 is connected to the water injection connector 20 and used, the usability is good.
　図１１は、第２実施形態の高周波処置具１０Ａを示した要部斜視図である。図１１に示すロックスイッチ７０は、コネクタ本体１８の外周面１８Ｃにおいて回転軸２８を中心とする周方向に複数の被係合部６２、６２…を備えたものであり、その他の構成は図９のロックスイッチ６０と同一である。図１１のロックスイッチ７０によれば、可動係合体６４に係合される被係合部６２を複数の被係合部６２、６２…の中から選択することができるので、回転ロック状態とした場合の注水コネクタ２０の向きを所望の位置に変更することができる。 FIG. 11 is a perspective view of a main part showing a high-frequency treatment instrument 10A according to the second embodiment. The lock switch 70 shown in FIG. 11 is provided with a plurality of engaged portions 62, 62... On the outer peripheral surface 18C of the connector main body 18 in the circumferential direction around the rotation shaft 28. Is the same as the lock switch 60 of FIG. According to the lock switch 70 of FIG. 11, the engaged portion 62 to be engaged with the movable engagement body 64 can be selected from a plurality of engaged portions 62, 62. In this case, the direction of the water injection connector 20 can be changed to a desired position.
　図１２は、第３実施形態の高周波処置具１０Ｂを示した要部斜視図である。図１２に示すロックスイッチ８０は、図１１の可動係合体６４に代えて、スライドスイッチ８２を備えている。 FIG. 12 is a perspective view of a main part showing a high-frequency treatment instrument 10B according to the third embodiment. The lock switch 80 shown in FIG. 12 includes a slide switch 82 instead of the movable engagement body 64 in FIG.
　スライドスイッチ８２は、スライドリング８４と、スライドリング８４に設けられた突起部８６と、を有する。スライドリング８４は、本体軸部３６の外周面３６Ｃに装着される。スライドリング８４の内周面には、凸状のガイド部８８が備えられている。このガイド部８８は、本体軸部３６の外周面３６Ｃに備えられたガイド溝６６に対し、スライド移動可能に係合されている。このガイド溝６６は、長手軸３６Ａに沿って備えられている。これにより、スライドリング８４は、本体軸部３６に対し、長手軸３６Ａに沿ってスライド移動自在に設けられている。 The slide switch 82 has a slide ring 84 and a projection 86 provided on the slide ring 84. The slide ring 84 is mounted on the outer peripheral surface 36 </ b> C of the main body shaft 36. On the inner peripheral surface of the slide ring 84, a convex guide portion 88 is provided. The guide portion 88 is slidably engaged with the guide groove 66 provided on the outer peripheral surface 36 </ b> C of the main body shaft portion 36. The guide groove 66 is provided along the longitudinal axis 36A. Thereby, the slide ring 84 is provided slidably with respect to the main body shaft 36 along the longitudinal axis 36A.
　このように構成されたスライドスイッチ８２によれば、スライドリング８４を被係合部６２に向けてスライド移動させると、突起部８６が被係合部６２に係合される。これにより、コネクタ本体１８は、回転不能にロックされた回転ロック状態となる。 According to the slide switch 82 configured as described above, when the slide ring 84 is slid toward the engaged portion 62, the protrusion 86 is engaged with the engaged portion 62. Thereby, the connector main body 18 is in a rotation locked state in which the connector main body 18 is locked so as not to rotate.
　また、スライドリング８４を被係合部６２から退避する方向にスライド移動させると、被係合部６２から突起部８６が退避することで、突起部８６と被係合部６２との係合が解除される。これにより、コネクタ本体１８は、回転ロック解除状態となる。 When the slide ring 84 is slid in the direction of retreating from the engaged portion 62, the projection 86 retreats from the engaged portion 62, and the engagement between the projection 86 and the engaged portion 62 is reduced. It is released. Thereby, the connector main body 18 is in the rotation lock released state.
　第３実施形態の高周波処置具１０Ｂによれば、上記のロックスイッチ８０を備えることにより、術者は、どのような操作姿勢であってもスライドリング８４を確認することができるので、回転ロック状態と回転ロック解除状態との切替操作性が向上し、使い勝手が更に向上する。 According to the high-frequency treatment device 10B of the third embodiment, by providing the lock switch 80, the operator can check the slide ring 84 regardless of the operation posture, so that the rotation lock state is achieved. The switching operability between the rotation lock release state and the rotation lock release state is improved, and the usability is further improved.
　図１３は、第４実施形態の高周波処置具１０Ｃを示した要部斜視図である。この高周波処置具１０Ｃは、コネクタ本体１８の回転を回転ロック状態と回転ロック解除状態に切り替える揺動式のロックスイッチ９０を備えている。 FIG. 13 is a perspective view of a main part showing a high-frequency treatment instrument 10C according to the fourth embodiment. This high-frequency treatment instrument 10C includes an oscillating lock switch 90 that switches the rotation of the connector main body 18 between a rotation lock state and a rotation lock release state.
　図１３の１３Ａ及び１３Ｂに示すように、ロックスイッチ９０は、コネクタ本体１８に備えられた被係合部９２と、本体軸部３６に備えられた可動係合体９４と、有している。 As shown in FIGS. 13A and 13B, the lock switch 90 includes an engaged portion 92 provided on the connector main body 18 and a movable engagement body 94 provided on the main body shaft 36.
　被係合部９２は、コネクタ本体１８の外周面１８Ｃにおいて凹状の溝部により構成されている。可動係合体１０４は、揺動スイッチを構成するものであり、揺動体９６と、被係合部１０２に係合可能な係合部９８と、を有している。 The engaged portion 92 is formed by a concave groove on the outer peripheral surface 18C of the connector main body 18. The movable engagement body 104 constitutes a swing switch, and has a swing body 96 and an engagement portion 98 that can be engaged with the engaged portion 102.
　揺動体９６と係合部９８とはそれぞれ板状であり、係合部９８は、揺動体９６の端部から突出した突起部により構成され、揺動体９６と係合部９８とは、その間に備えられた軸受部９９を介して側面視Ｖ字状に構成されている。軸受部９９は、本体軸部３６の外周面３６Ｃに設けられたピン１００を中心に揺動可能に設けられており、このピン１００は、回転軸２８の方向と直交する方向に取り付けられている。 The oscillating body 96 and the engaging portion 98 are each plate-shaped, and the engaging portion 98 is formed by a protruding portion protruding from an end of the oscillating body 96, and the oscillating body 96 and the engaging portion 98 are interposed therebetween. It is configured in a V-shape in side view via a provided bearing portion 99. The bearing portion 99 is provided so as to be able to swing around a pin 100 provided on the outer peripheral surface 36 </ b> C of the main body shaft portion 36, and the pin 100 is attached in a direction orthogonal to the direction of the rotating shaft 28. .
　第４実施形態の高周波処置具１０Ｃによれば、上記のようなロックスイッチ９０を備えることにより、以下の効果を得ることができる。例えば、注水コネクタ２０にシリンジ３２を接続して使用する場合、係合部９８が被係合部９２に係合する位置（すなわち、被係合部９２が係合部９８と対向する位置）にコネクタ本体１８を回転させた後、揺動体９６を矢印Ｃ方向に揺動させて係合部９８を被係合部９２に係合させてコネクタ本体１８を回転ロック状態とする。これにより、第１実施形態の高周波処置具１０と同様に、シリンジ３２を接続した場合の操作性が向上し、使い勝手がよくなる。また、注水コネクタ２０に図８の送水チューブ３４を接続して使用する場合には、揺動体９６を矢印Ｄ方向に揺動させて係合部９８を被係合部９２から退避移動させてコネクタ本体１８を回転ロック解除状態とする。これにより、第１実施形態の高周波処置具１０と同様に、送水チューブ３４を接続した場合の操作性が向上し、使い勝手がよくなる。 According to the high frequency treatment device 10C of the fourth embodiment, the following effects can be obtained by providing the lock switch 90 as described above. For example, when the syringe 32 is connected to the water injection connector 20 and used, the engagement portion 98 is at a position where the engagement portion 98 is engaged with the engaged portion 92 (ie, a position where the engaged portion 92 faces the engagement portion 98). After the connector main body 18 is rotated, the swinging body 96 is swung in the direction of arrow C to engage the engaging portion 98 with the engaged portion 92, thereby bringing the connector main body 18 into a rotation locked state. Thereby, similarly to the high frequency treatment device 10 of the first embodiment, the operability when the syringe 32 is connected is improved, and the usability is improved. When the water supply tube 34 shown in FIG. 8 is connected to the water injection connector 20 for use, the swinging body 96 is swung in the direction of arrow D to move the engaging portion 98 away from the engaged portion 92 to move the connector. The main body 18 is brought into the rotation lock released state. Thereby, similarly to the high-frequency treatment instrument 10 of the first embodiment, the operability when the water supply tube 34 is connected is improved, and the usability is improved.
　図１４は、第５実施形態の高周波処置具１０Ｄを示した要部斜視図である。図１４に示すロックスイッチ１１０は、コネクタ本体１８の外周面１８Ｃにおいて回転軸２８を中心とする周方向に複数の被係合部９２、９２…を備えたものであり、その他の構成は図１３のロックスイッチ９０と同一である。図１４のロックスイッチ１１０によれば、係合部９８に係合される被係合部９２を複数の被係合部９２、９２…の中から選択することができるので、回転ロック状態とした場合の注水コネクタ２０の向きを所望の位置に変更することができる。 FIG. 14 is a perspective view of a main part showing a high-frequency treatment instrument 10D according to the fifth embodiment. The lock switch 110 shown in FIG. 14 is provided with a plurality of engaged portions 92, 92... In the circumferential direction around the rotation shaft 28 on the outer peripheral surface 18C of the connector main body 18, and the other configuration is shown in FIG. Is the same as the lock switch 90 of FIG. According to the lock switch 110 of FIG. 14, the engaged portion 92 to be engaged with the engaging portion 98 can be selected from a plurality of engaged portions 92, 92. In this case, the direction of the water injection connector 20 can be changed to a desired position.
　図１５は、第６実施形態の高周波処置具１０Ｅを示した要部斜視図である。図１５に示す本体軸部３６は、連結部材１２０を有し、この連結部材１２０は、本体軸部３６にコネクタ本体１８を連結することでコネクタ本体１８を回転不能にロックする回転ロック状態から、連結を解除することでコネクタ本体１８を回転可能にする回転ロック解除状態に遷移させることができる。 FIG. 15 is a perspective view of a main part showing a high-frequency treatment instrument 10E according to the sixth embodiment. The main body shaft portion 36 shown in FIG. 15 has a connecting member 120. The connecting member 120 is connected to the main body shaft portion 36 to lock the connector main body 18 in a non-rotatable state. By releasing the connection, it is possible to make a transition to a rotation lock release state in which the connector main body 18 can be rotated.
　図１５に示す連結部材１２０は、一例として、回転力が伝達されることにより破断可能な複数のブリッジ片１２２、１２２…によって構成されている。これらのブリッジ片１２２、１２２…は、本体軸部３６の先端の周囲に間隔を開けて備えられて、コネクタ本体１８の基端の周囲に連結されている。 連結 As an example, the connecting member 120 shown in FIG. 15 includes a plurality of bridge pieces 122 that can be broken by transmitting a rotational force. Are provided at intervals around the distal end of the main body shaft portion 36, and are connected around the proximal end of the connector main body 18.
　これらのブリッジ片１２２、１２２…が破断される前の状態では、コネクタ本体１８は、ブリッジ片１２２、１２２…を介して本体軸部３６に連結されているので、回転ロック状態に保持される。これに対して、コネクタ本体１８を本体軸部３６に対して回転軸２８を中心に回転させると、その回転力によってブリッジ片１２２、１２２…が全て破断される。つまり、ブリッジ片１２２、１２２…が全て破断された場合、コネクタ本体１８は、回転ロック状態から回転ロック解除状態に遷移する。 コ ネ ク タ Before these bridge pieces 122 are broken, the connector main body 18 is connected to the main body shaft portion 36 via the bridge pieces 122, 122. On the other hand, when the connector main body 18 is rotated about the rotary shaft 28 with respect to the main body shaft portion 36, all of the bridge pieces 122 are broken by the rotational force. That is, when all of the bridge pieces 122 are broken, the connector main body 18 transitions from the rotation lock state to the rotation lock release state.
　第６実施形態の高周波処置具１０Ｅによれば、上記のような連結部材１２０を備えることにより、以下の効果を得ることができる。例えば、注水コネクタ２０に図７のシリンジ３２を接続する場合には、回転ロック状態を保持する。これにより、第１実施形態の高周波処置具１０と同様に、シリンジ３２を接続した場合の操作性が向上し、使い勝手がよくなる。また、注水コネクタ２０に図８の送水チューブ３４を接続して使用する場合には、コネクタ本体１８を本体軸部３６に対して回転させることにより、ブリッジ片１２２、１２２…を全て破断して回転ロック解除状態とする。これにより、第１実施形態の高周波処置具１０と同様に、送水チューブ３４を接続した場合の操作性が向上し、使い勝手がよくなる。 According to the high-frequency treatment device 10E of the sixth embodiment, the following effects can be obtained by providing the above-described connecting member 120. For example, when connecting the syringe 32 of FIG. 7 to the water injection connector 20, the rotation locked state is maintained. Thereby, similarly to the high frequency treatment device 10 of the first embodiment, the operability when the syringe 32 is connected is improved, and the usability is improved. When the water supply tube 34 shown in FIG. 8 is connected to the water injection connector 20 for use, the connector body 18 is rotated with respect to the main body shaft 36 to break all the bridge pieces 122, 122,. The lock is released. Thereby, similarly to the high-frequency treatment instrument 10 of the first embodiment, the operability when the water supply tube 34 is connected is improved, and the usability is improved.
　第６実施形態の高周波処置具１０Ｅによれば、ブリッジ片１２２、１２２…を全て破断した場合には、コネクタ本体１８を回転ロック状態から回転ロック解除状態に遷移させることができるので、１回の使用で廃棄されるディスポーザブルタイプの高周波処置具１０Ｅに好適となる。 According to the high-frequency treatment device 10E of the sixth embodiment, when all the bridge pieces 122, 122,... Are broken, the connector main body 18 can be transitioned from the rotation lock state to the rotation lock release state. This is suitable for the disposable type high-frequency treatment tool 10E that is discarded during use.
１０　　　高周波処置具
１０Ａ　　高周波処置具
１０Ｂ　　高周波処置具
１０Ｃ　　高周波処置具
１０Ｄ　　高周波処置具
１０Ｅ　　高周波処置具
１２　　　シース
１４　　　ワイヤ
１６　　　高周波ナイフ
１８　　　コネクタ本体
１８Ａ　　開口
１８Ｃ　　外周面
１９Ａ　　指掛け部
１９Ｂ　　滑り止め部
２０　　　注水コネクタ
２２　　　操作部本体
２４　　　内部空間
２６　　　先端
２８　　　回転軸
３０　　　中心軸
３２　　　シリンジ
３４　　　送水チューブ
３６　　　本体軸部
３６Ｃ　　外周面
３８　　　スライダ
４０　　　電気コネクタ
４２　　　連結管
４４　　　Ｏリング
４６　　　指掛けリング
４８　　　スリット
５０　　　筒部
５２　　　指掛けリング
５４　　　指掛けリング
５６　　　コア
６０　　　ロックスイッチ
６２　　　被係合部
６４　　　可動係合体
６６　　　ガイド溝
７０　　　ロックスイッチ
８０　　　ロックスイッチ
８２　　　スライドスイッチ
８４　　　スライドリング
８６　　　突起部
８８　　　ガイド部
９０　　　ロックスイッチ
９２　　　被係合部
９４　　　可動係合体
９６　　　揺動体
９８　　　係合部
１００　　ピン
１１０　　ロックスイッチ
１２０　　連結部材
１２２　　ブリッジ片 DESCRIPTION OF SYMBOLS 10 High-frequency treatment tool 10A High-frequency treatment tool 10B High-frequency treatment tool 10C High-frequency treatment tool 10D High-frequency treatment tool 10E High-frequency treatment tool 12 Sheath 14 Wire 16 High-frequency knife 18 Connector body 18A Opening 18C Outer peripheral surface 19A Finger hook portion 19B Non-slip portion 20 Water injection connector 22 Operation unit main body 24 Internal space 26 Tip 28 Rotary shaft 30 Central shaft 32 Syringe 34 Water supply tube 36 Main shaft 36C Outer peripheral surface 38 Slider 40 Electrical connector 42 Connecting tube 44 O-ring 46 Finger ring 48 Slit 50 Tube part 52 Finger ring 54 Finger ring Ring 56 Core 60 Lock switch 62 Engaged part 64 Movable engaging body 66 Guide groove 70 Lock switch 80 Lock switch 82 Slide switch 84 Slide ring 6 protrusions 88 guide portion 90 lock switch 92 engaged portion 94 movable engager 96 oscillator 98 engaging section 100 pin 110 lock switch 120 connecting member 122 bridge piece

Claims (10)

  1. 　可撓性のシースと、
    　前記シースの内部に挿通されたワイヤと、
    　前記ワイヤの先端に設けられた処置部と、
    　前記シースの基端が連結された筒状のコネクタ本体と、
    　前記コネクタ本体に設けられた注水コネクタと、
    　前記コネクタ本体の基端に連結された操作部本体であって、前記ワイヤを前記シースの軸線方向に進退操作することにより前記処置部を前記シースの先端から突没させる操作部本体と、
    　を備え、
    　前記コネクタ本体は、前記操作部本体に対し回転軸を中心に回転自在に連結され、
    　前記コネクタ本体は、被係合部を有し、
    　前記操作部本体は、前記被係合部に係合されて前記コネクタ本体を回転不能にロックする回転ロック状態と、前記係合が解除されて前記コネクタ本体を回転可能にする回転ロック解除状態との間で動作可能な可動係合体を有する、
    　内視鏡処置具。     A flexible sheath;
    A wire inserted inside the sheath,
    A treatment unit provided at the tip of the wire,
    A tubular connector body to which the proximal end of the sheath is connected,
    A water injection connector provided on the connector body,
    An operation unit main body connected to the proximal end of the connector main body, wherein the operation unit main body causes the treatment section to protrude and retract from a distal end of the sheath by operating the wire in an axial direction of the sheath.
    With
    The connector body is rotatably connected to the operation unit body about a rotation axis,
    The connector body has an engaged portion,
    A rotating lock state in which the operating portion main body is engaged with the engaged portion to lock the connector main body in a non-rotatable manner; and a rotation lock releasing state in which the engagement is released and the connector main body is rotatable. Having a movable engagement body operable between
    Endoscope treatment tool.
  2. 　前記可動係合体は、前記回転軸の軸方向にスライド移動可能なスライドスイッチである、
    　請求項１に記載の内視鏡処置具。     The movable engagement body is a slide switch slidable in the axial direction of the rotation shaft.
    The endoscope treatment tool according to claim 1.
  3. 　前記スライドスイッチは、スライドリングと、前記スライドリングに設けられた突起部とを有し、前記スライドリングが前記回転軸の軸方向にスライド移動することで前記突起部が前記被係合部に係合して前記回転ロック状態となる、
    　請求項２に記載の内視鏡処置具。     The slide switch has a slide ring and a protrusion provided on the slide ring, and the slide ring slides in the axial direction of the rotation shaft so that the protrusion is engaged with the engaged portion. In the rotation locked state in combination,
    The endoscope treatment tool according to claim 2.
  4. 　前記可動係合体は、前記回転軸の軸方向に直交する方向を中心に揺動可能な揺動スイッチである、
    　請求項１に記載の内視鏡処置具。     The movable engagement body is a swing switch that can swing around a direction orthogonal to the axial direction of the rotation shaft.
    The endoscope treatment tool according to claim 1.
  5. 　前記揺動スイッチは、揺動体と、前記揺動体に設けられた突起部とを有し、前記揺動体が前記回転軸の軸方向に直交する方向を中心に揺動することで前記突起部が前記被係合部に係合して前記回転ロック状態となる、
    　請求項４に記載の内視鏡処置具。     The rocking switch has a rocking body and a protrusion provided on the rocking body, and the rocking body rocks around a direction perpendicular to the axial direction of the rotation shaft, so that the protrusion is formed. Engaging with the engaged portion to be in the rotation locked state,
    The endoscope treatment tool according to claim 4.
  6. 　前記被係合部は、前記コネクタ本体における前記回転軸の周方向に複数備えられる、
    　請求項１から５のいずれか１項に記載の内視鏡処置具。     A plurality of the engaged portions are provided in a circumferential direction of the rotating shaft in the connector body.
    The endoscope treatment tool according to any one of claims 1 to 5.
  7. 　可撓性のシースと、
    　前記シースの内部に挿通されたワイヤと、
    　前記ワイヤの先端に設けられた処置部と、
    　前記シースの基端が連結された筒状のコネクタ本体と、
    　前記コネクタ本体に設けられた注水コネクタと、
    　前記コネクタ本体の基端に連結された操作部本体であって、前記ワイヤを前記シースの軸線方向に進退操作することにより前記処置部を前記シースの先端から突没させる操作部本体と、
    　を備え、
    　前記コネクタ本体は、前記操作部本体に対し回転軸を中心に回転自在に連結され、
    　前記操作部本体は、前記操作部本体に前記コネクタ本体を連結することで前記コネクタ本体を回転不能にロックする回転ロック状態から、前記連結を解除することで前記コネクタ本体を回転可能にする回転ロック解除状態に遷移可能な連結部材を有する、
    　内視鏡処置具。     A flexible sheath;
    A wire inserted inside the sheath,
    A treatment unit provided at the tip of the wire,
    A tubular connector body to which the proximal end of the sheath is connected,
    A water injection connector provided on the connector body,
    An operation unit main body connected to the proximal end of the connector main body, wherein the operation unit main body causes the treatment section to protrude and retract from a distal end of the sheath by operating the wire in an axial direction of the sheath.
    With
    The connector body is rotatably connected to the operation unit body about a rotation axis,
    The operation unit main body is configured to rotate the connector main body by rotating the connector main body by releasing the connection from a rotation lock state in which the connector main body is connected to the operation unit main body to lock the connector main body in a non-rotatable manner. Having a connecting member that can transition to a release state,
    Endoscope treatment tool.
  8. 　前記回転軸を水平方向のうち第１方向に沿って配置した状態において、前記注水コネクタの中心軸が水平方向のうち前記第１方向に直交する第２方向を向いた場合の前記コネクタ本体の回転角度を基準角度とした場合、
    　前記回転ロック状態における前記コネクタ本体の回転角度と、前記基準角度との角度差が４５度以内の範囲である、
    　請求項１から７のいずれか１項に記載の内視鏡処置具。     Rotation of the connector main body when the center axis of the water injection connector is oriented in a second direction orthogonal to the first direction in the horizontal direction in a state where the rotation axis is arranged along the first direction in the horizontal direction. When the angle is the reference angle,
    An angle difference between the rotation angle of the connector main body in the rotation locked state and the reference angle is within a range of 45 degrees.
    An endoscope treatment tool according to any one of claims 1 to 7.
  9. 　前記注水コネクタの中心軸は、前記回転軸と直交している、
    　請求項１から８のいずれか１項に記載の内視鏡処置具。     The central axis of the water injection connector is orthogonal to the rotation axis,
    An endoscope treatment tool according to any one of claims 1 to 8.
  10. 　前記操作部本体は、
    　前記コネクタ本体が回転自在に連結されて前記回転軸の方向に延出された本体軸部と、
    　前記本体軸部に沿って移動自在に設けられ、前記ワイヤの基端部が連結されたスライダと、
    　前記スライダに設けられ、前記ワイヤの基端部に電気的に接続された電気コネクタと、を有し、
    　前記処置部に通電可能である、
    　請求項１から９のいずれか１項に記載の内視鏡処置具。     The operation unit main body includes:
    A main body shaft portion in which the connector main body is rotatably connected and extends in the direction of the rotation axis;
    A slider movably provided along the main body shaft, and a base end of the wire connected thereto;
    An electrical connector provided on the slider and electrically connected to a base end of the wire;
    The treatment unit can be energized,
    The endoscope treatment tool according to any one of claims 1 to 9.
PCT/JP2019/024528 2018-07-23 2019-06-20 Endoscopic treatment instrument WO2020021923A1 (en)

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Publication number Priority date Publication date Assignee Title
WO2023242407A1 (en) * 2022-06-17 2023-12-21 Creo Medical Ltd Interface joint

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